Individual provider Active NPI

Kirsten Anne Jacobson, LCSW

  • Clinical Social Worker
  • Layton, UT
National Provider Identifier
1730456104
Registry record updated Oct 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7746360-3501 Issued in UT
Practice address
1133 N Main St Ste 100
Layton, UT 84041-4868
Phone
(801) 833-7536
NPI assigned
Nov 29, 2011
Last updated
Oct 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 7746360-3502 UT
Clinical Social Worker 1041C0700X 746360-3501 UT
Clinical Social Worker 1041C0700X 7746360-3501 UT Primary

Addresses

Primary practice location

1133 N Main St Ste 100
Layton, UT 84041-4868

Mailing address

1133 N Main St Ste 100
Layton, UT 84041-4868
Phone (801) 833-7536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7746360-3502UTMDSocial Worker
746360-3501UTMDClinical Social Worker
7746360-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mountainside Counseling Services Clinical CurrentSince Feb 19, 2023 Accepting new patients
Mountainside Neurotherapy Current Accepting new patients

Locations

1133 N Main St
Ste 100
Layton, UT 84041
Phone (503) 925-3095

1133 N Main St
Ste 130
Layton, UT 84041
Phone (801) 628-6397

2834 S 1900 W
Ogden, UT 84401
Phone (801) 608-8056

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1322524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791072000000",
    "number": "1730456104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 N MAIN ST STE 100",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840414868",
            "telephone_number": "801-833-7536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 N MAIN ST STE 100",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840414868",
            "telephone_number": "801-833-7536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "KIRSTEN",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-29",
        "last_updated": "2026-10-04",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": "7746360-3502",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "746360-3501",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "7746360-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2026; 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.