Individual provider Active NPI

Betty Roos

  • Marriage & Family Therapist
  • Midvale, UT
National Provider Identifier
1952820318
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
75 E Fort Union Blvd Ste 135
Midvale, UT 84047-1531
Phone
(801) 603-2547
NPI assigned
Sep 16, 2017
Last updated
Nov 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 12394257-3902 UT
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

75 E Fort Union Blvd Ste 135
Midvale, UT 84047-1531

Mailing address

PO Box 12842
Ogden, UT 84412-2842
Phone (801) 603-2547

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
12394257-3902UTMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1505520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1952820318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12842",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844122842",
            "telephone_number": "801-603-2547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 E FORT UNION BLVD STE 135",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471531",
            "telephone_number": "801-603-2547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOS",
        "first_name": "BETTY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-16",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "12394257-3902",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midvale, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.

Verify at the official NPI Registry.