NPIMap

Organization Active NPI

Salt Lake County for Its Youth Services Division

  • Addiction (Substance Use Disorder) Counselor
  • South Salt Lake City, UT
National Provider Identifier
1912125337
Registry record updated May 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1169286004 Issued in UT
Legal business name
SALT LAKE COUNTY FOR ITS YOUTH SERVICES DIVISION
Practice address
177 West Price Ave
South Salt Lake City, UT 84115-4345
Phone
(801) 269-7500
Fax
(801) 269-7550
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2012

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

Authorized official

Name
Mrs. Carolyn Hansen, LCSW
Title
Division Director
Phone
(385) 468-4501

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X 47632166004 UT
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X 1169286004 UT Primary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X 3470473502 UT
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X 56931903502 UT

Addresses

Primary practice location

177 West Price Ave
South Salt Lake City, UT 84115-4345

Mailing address

2001 South State Street
Suite N4100
Salt Lake City, UT 84190-1021
Phone (801) 468-2332

Other identifiers 2

IdentifierTypeStateIssuer
HT0004001MedicaidUT
HT002258OtherUTUTAH HEALTH

National Provider Directory

National Provider Directory
Tax ID family
S L Mental Heath12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336435200000",
    "number": "1912125337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 SOUTH STATE STREET",
            "address_2": "SUITE N4100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841901021",
            "telephone_number": "801-468-2332",
            "fax_number": "801-468-3712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 WEST PRICE AVE",
            "city": "SOUTH SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841154345",
            "telephone_number": "801-269-7500",
            "fax_number": "801-269-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALT LAKE COUNTY FOR ITS YOUTH SERVICES DIVISION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2012-05-08",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "DIVISION DIRECTOR",
        "authorized_official_telephone_number": "385-468-4501",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "UT",
            "license": "47632166004",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "UT",
            "license": "1169286004",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "UT",
            "license": "3470473502",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "UT",
            "license": "56931903502",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HT0004001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UTAH HEALTH",
            "identifier": "HT002258",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South 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 May 8, 2012; 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.