Active NPI
Andrew Sean Jones, MA, PH.D
- Psychologist
- Salt Lake City, UT
National Provider Identifier
1922673136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 13820914-2501
- Practice address
- 240 Morris Ave Ste 100
Salt Lake City, UT 84115-3278 - Phone
- (801) 823-1486
- NPI assigned
- May 21, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 103406 | NC | |
| Psychologist | 103T00000X | 1873 | SC | |
| Psychologist | 103T00000X | 4040 | TN | |
| Psychologist | 103T00000X | 13820914-2501 | UT | Primary |
Addresses
Primary practice location
240 Morris Ave Ste 100
Salt Lake City, UT 84115-3278
Mailing address
16255 Ventura Blvd Ste 900
Encino, CA 91436-2317
Phone (801) 935-4171
Other practice location 1
138 Barium Springs Dr
Statesville, NC 28677-8453
Phone (704) 832-2200
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13820914-2501 | Other | UT | LICENSE |
| 103406 | Other | NC | LICENSE |
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
- Credentials
- Master of Arts, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103406 | NC | MD | Psychologist |
| 13820914-2501 | UT | MD | Psychologist |
| 4040 | TN | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Psychological Institute, PLLC | Psychologist | Current | Accepting new patients |
| Barium Springs Home for Children | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychologist
- Charlotte, NC
- NPI 1821882457
-
- Psychiatric Residential Treatment Facility
- Statesville, NC
- NPI 1093916751
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728345600000",
"number": "1922673136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16255 VENTURA BLVD STE 900",
"city": "ENCINO",
"state": "CA",
"postal_code": "914362317",
"telephone_number": "801-935-4171",
"fax_number": "704-838-1541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 MORRIS AVE STE 100",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841153278",
"telephone_number": "801-823-1486"
}
],
"practiceLocations": [
{
"address_1": "138 Barium Springs Dr",
"address_purpose": "LOCATION",
"city": "Statesville",
"state": "NC",
"postal_code": "286778453",
"country_code": "US",
"telephone_number": "704-832-2200",
"fax_number": "704-838-1541",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JONES",
"first_name": "ANDREW",
"middle_name": "SEAN",
"credential": "MA, PH.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-21",
"last_updated": "2024-10-08",
"certification_date": "2024-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "103406",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "SC",
"license": "1873",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TN",
"license": "4040",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "UT",
"license": "13820914-2501",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "13820914-2501",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "103406",
"state": "NC"
}
],
"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 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.