Active NPI
Jennifer Elledge
- Marriage & Family Therapist
- Salt Lake City, UT
National Provider Identifier
1811399207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMT 2138
- Practice address
- 2040 E Murray Holladay Rd
Salt Lake City, UT 84117-5185 - Phone
- (801) 285-6036
- Fax
- (316) 462-0994
- NPI assigned
- Sep 17, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMT 2138 | FL | Primary |
Addresses
Primary practice location
2040 E Murray Holladay Rd
Salt Lake City, UT 84117-5185
Mailing address
2616 Wembleycross Way
Orlando, FL 32828-7963
Phone (407) 575-8077
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMT 2138 | FL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776124800000",
"number": "1811399207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2616 WEMBLEYCROSS WAY",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328287963",
"telephone_number": "407-575-8077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2040 E MURRAY HOLLADAY RD",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841175185",
"telephone_number": "801-285-6036",
"fax_number": "316-462-0994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLEDGE",
"first_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-17",
"last_updated": "2026-04-14",
"certification_date": "2026-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "FL",
"license": "IMT 2138",
"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 14, 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.