NPIMap

Organization Active NPI

Breakaway Counseling, LLC

  • Clinical Social Worker
  • South Jordan, UT
National Provider Identifier
1972485035
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
BREAKAWAY COUNSELING, LLC
Practice address
489 W South Jordan Pkwy Ste 256
South Jordan, UT 84095-3979
Phone
(801) 871-5799
NPI assigned
Jul 21, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Authorized official

Name
Laura Matson, LCSWNPI 1407580723
Title
President
Phone
(801) 633-2507

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)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

489 W South Jordan Pkwy Ste 256
South Jordan, UT 84095-3979

Mailing address

11153 S Devon View Dr
South Jordan, UT 84095-4142
Phone (801) 633-2507

National Provider Directory

National Provider Directory

Locations

489 W South Jordan Pkwy
Ste 256
South Jordan, UT 84095
Phone (801) 871-5799

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1753056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753056000000",
    "number": "1972485035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11153 S DEVON VIEW DR",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840954142",
            "telephone_number": "801-633-2507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 W SOUTH JORDAN PKWY STE 256",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840953979",
            "telephone_number": "801-871-5799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAKAWAY COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-21",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A",
        "authorized_official_last_name": "MATSON",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-633-2507",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2025; 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.