Individual provider Active NPI

Jessica J Cleeves

  • Mental Health Counselor
  • Salt Lake City, UT
National Provider Identifier
1861062341
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11388808-3502 Issued in UT
Practice address
466 S 500 E # 200
Salt Lake City, UT 84102-2705
Phone
(801) 449-0454
NPI assigned
Jun 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 11388808-3502 UT Primary

Addresses

Primary practice location

466 S 500 E # 200
Salt Lake City, UT 84102-2705

Mailing address

1953 S 1100 E Unit 521124
Salt Lake City, UT 84152-5064
Phone (801) 449-0454

Other identifiers 1

IdentifierTypeStateIssuer
NAOtherNA

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL https://drive.google.com/drive/folders/16_eJWC3qCDykR5zQn9njjh_R2bXCUdBF?usp=sharing Direct
Other URL https://drive.google.com/drive/folders/16_eJWC3qCDykR5zQn9njjh_R2bXCUdBF?usp=sharing Direct

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

LicenseStateTypeSpecialty
11388808-3502UTMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1861062341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1953 S 1100 E UNIT 521124",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841525064",
            "telephone_number": "801-449-0454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "466 S 500 E # 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022705",
            "telephone_number": "801-449-0454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEEVES",
        "first_name": "JESSICA",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "11388808-3502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://drive.google.com/drive/folders/16_eJWC3qCDykR5zQn9njjh_R2bXCUdBF?usp=sharing",
            "affiliation": "N",
            "endpointDescription": "HIPAA-compliant Drive folder",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PDF, Word, and other images",
            "address_1": "466 S 500 E # 200",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841022705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://drive.google.com/drive/folders/16_eJWC3qCDykR5zQn9njjh_R2bXCUdBF?usp=sharing",
            "affiliation": "N",
            "endpointDescription": "HIPAA compliant Drive folder",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Word, PDF, and image files",
            "address_1": "466 S 500 E # 200",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841022705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jun 28, 2021; 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.