Active NPI
Support One Health Services
- Mental Health Counselor
- Bluffdale, UT
National Provider Identifier
1922643949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Legal business name
- SUPPORT ONE HEALTH SERVICES
- Practice address
- 15041 S Gallant Dr
Bluffdale, UT 84065-4987 - Phone
- (925) 565-6414
- NPI assigned
- Nov 13, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Craig Baker, MFT
- Title
- Director
- Phone
- (925) 565-6414
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
15041 S Gallant Dr
Bluffdale, UT 84065-4987
Mailing address
15041 S Gallant Dr
Bluffdale, UT 84065-4987
Other practice location 1
1206 W South Jordan Pkwy
South Jordan, UT 84095-5511
Phone (925) 565-6414
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Social Worker
- South Jordan, UT
- NPI 1831337104
-
- Case Manager/Care Coordinator
- South Salt Lake, UT
- NPI 1114895661
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573603200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1573603200000",
"number": "1922643949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15041 S GALLANT DR",
"city": "BLUFFDALE",
"state": "UT",
"postal_code": "840654987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15041 S GALLANT DR",
"city": "BLUFFDALE",
"state": "UT",
"postal_code": "840654987",
"telephone_number": "925-565-6414"
}
],
"practiceLocations": [
{
"address_1": "1206 W South Jordan Pkwy",
"address_purpose": "LOCATION",
"city": "South Jordan",
"state": "UT",
"postal_code": "840955511",
"country_code": "US",
"telephone_number": "925-565-6414",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "SUPPORT ONE HEALTH SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2019-11-13",
"last_updated": "2019-11-13",
"status": "A",
"authorized_official_last_name": "BAKER",
"authorized_official_first_name": "CRAIG",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "925-565-6414",
"authorized_official_credential": "MFT"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bluffdale, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.