Jacob R Andreason

Individual provider Active NPI Mental Health Counselor · South Jordan, UT

NPI 1992011860 · NPPES record last updated Mar 10, 2023

Key facts

NPI
1992011860
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
10808 S River Front Pkwy Ste 308
South Jordan, UT 84095-5761
Phone
(801) 984-6728
Fax
(801) 984-4715
NPI assigned
Aug 29, 2010
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Theory Counseling LLC Mental Health Current
since Feb 26, 2023
Accepting new patients

Locations

10808 S River Front Pkwy
Ste 308
South Jordan, UT 84095
Phone (801) 984-6726

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

10808 S River Front Pkwy Ste 308
South Jordan, UT 84095-5761

Mailing address

10808 S River Front Pkwy Ste 308
South Jordan, UT 84095-5761
Phone (801) 984-6728

Other providers in South Jordan, UT

All providers in South Jordan, UT · Mental Health Counselor in Utah

Sources for this page

Verify at the official NPI Registry.