NPIMap

Organization Active NPI

Blue Clover Therapy

  • Mental Health Counselor
  • Salt Lake City, UT
National Provider Identifier
1700249844
Registry record updated Apr 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
9706026-0160 Issued in UT
Legal business name
BLUE CLOVER THERAPY
Practice address
2825 E Cottonwood Pkwy
Suite 500
Salt Lake City, UT 84121-7055
Phone
(801) 206-4321
NPI assigned
Apr 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jessie Shepherd, LCMHCNPI 1316207301
Title
Owner Therapist
Phone
(801) 206-4321

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 9706026-0160 UT Primary

Addresses

Primary practice location

2825 E Cottonwood Pkwy
Suite 500
Salt Lake City, UT 84121-7055

Mailing address

2825 E Cottonwood Pkwy
Suite 500
Salt Lake City, UT 84121-7055
Phone (801) 206-4321

National Provider Directory

National Provider Directory

Locations

6860 Dallas Pkwy
Ste 227
Plano, TX 75024

2455 E Parleys Way
Ste 205
Salt Lake City, UT 84109
Phone (801) 206-4321

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459814400000",
    "number": "1700249844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 E COTTONWOOD PKWY",
            "address_2": "SUITE 500",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841217055",
            "telephone_number": "801-206-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 E COTTONWOOD PKWY",
            "address_2": "SUITE 500",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841217055",
            "telephone_number": "801-206-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE CLOVER THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-05",
        "last_updated": "2016-04-05",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "OWNER THERAPIST",
        "authorized_official_telephone_number": "801-206-4321",
        "authorized_official_credential": "LCMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "9706026-0160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.