Individual provider Active NPI

Jessica B. Jeffs, CMCH

  • Mental Health Counselor
  • Salt Lake City, UT
National Provider Identifier
1912205824
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
7627014-6004 Issued in UT
Practice address
440 S 500 E
Salt Lake City, UT 84102
Phone
(801) 359-8862
Fax
(801) 359-8510
NPI assigned
Mar 2, 2011
Last updated
Oct 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 7627014-6009 UT
Mental Health Counselor 101YM0800X 7627014-6004 UT Primary

Addresses

Primary practice location

440 S 500 E
Salt Lake City, UT 84102

Mailing address

440 S 500 E
Salt Lake City, UT 84102-2705
Phone (801) 359-8862

Other practice location 1

440 S 500 E
Salt Lake City, UT 84102
Phone (801) 359-8862 ext. 2164

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
7627014-6004UTMDMental Health Counselor
7627014-6009UTMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1912205824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 S 500 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022705",
            "telephone_number": "801-359-8862",
            "fax_number": "801-359-8510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 S 500 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84102",
            "telephone_number": "801-359-8862",
            "fax_number": "801-359-8510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "440 S 500 E",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "84102",
            "country_code": "US",
            "telephone_number": "801-359-8862 x2164",
            "fax_number": "801-359-8510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEFFS",
        "first_name": "JESSICA",
        "middle_name": "B.",
        "credential": "CMCH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-02",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "UT",
            "license": "7627014-6009",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "7627014-6004",
            "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 Oct 4, 2019; 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.