JACOB EUGENE JACQUEZ (NPI# 1841571353) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841571353 |
| Entity Type | Individual |
| Full Name | JACOB EUGENE JACQUEZ |
| Credential | LCSW |
| Practice Address |
5814 S 900 E Murray UT 84121-1644 |
| Practice Telephone | 3858003272 |
| Practice Fax Number | 3858003260 |
| Mailing Telephone | 8015489696 |
| Mailing Fax Number | 3858003260 |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2020-07-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
7915180-3501 | UT | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
9923377 | CO | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
LCSW-871 | WY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 1025579 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5802 S 900 E, Murray, UT 841211644 | 8018344548 | 8444882768 |
| Street Address |
5814 S 900 E |
| City | MURRAY |
| State | UT |
| Zip Code | 84121-1644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821318346 | Brenda Joyce Dowse | Social Worker | 5814 S 900 E, Murray, UT 84121-1644 | 2010-06-07 |
| 1649804980 | Mona Lisa Chavez Esqueda | Social Worker | 5814 S 900 E, Murray, UT 84121-1644 | 2020-02-25 |
| 1568010213 | Marie Eileen West | Counselor | 5814 S 900 E, Murray, UT 84121-1644 | 2019-08-27 |
| 1548796931 | Empowering Relief Counseling, Pllc | Social Worker | 5814 S 900 E, Murray, UT 84121-1644 | 2017-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407483522 | Kaitlyn Horne | Behavior Technician | 6910 S. Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-26 |
| 1952936387 | Jared Wells | Behavior Technician | 6910 S Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-05 |
| 1518591874 | Slc Plastic Surgery LLC | Plastic Surgery | 6686 Highland Drive, Cottonwood Heights, UT 84121 | 2020-02-26 |
| 1093273708 | Anna O'hearon | Counselor | New Roads Behavioral Health, 2450 Fort Union Blvd, Cottonwood Heights, UT 84121 | 2019-03-12 |
| 1053883181 | Charles Keller IIi | Pediatrics | 2198 S Yvonne Rd #344, Salt Lake City, UT 84121 | 2018-12-31 |
| 1669964516 | Marissa King | Specialist | 1141 E. 3900 S. Suite 150a, Salt Lake, UT 84121 | 2018-06-05 |
| 1376044313 | Slpd Cottonwood LLC | Dentist | 7167 South Highland Drive, 200, Cottonwood Heights, UT 84121 | 2018-02-26 |
| 1700315462 | Nelson & Tillmann Family Dentistry, PC | Dentist | 5872 S. 900 E. Ste 202, Salt Lake City, UT 84121 | 2017-06-07 |
| 1912430588 | Wasatch Midwifery and Wellness, LLC | Dietitian, Registered | 6440 S Wasatch Blvd, Ste 140, Holladay, UT 84121 | 2017-04-10 |
| 1407308331 | Tina Polgar | Registered Nurse | 6244 Highland Drive, Murray, UT 84121 | 2016-10-26 |
| Find all providers in zip 84121 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043833460 | Mary Elizabeth Andolsek | Social Worker | 5411 S Vine St # 6, Murray, UT 84107-7746 | 2020-05-20 |
| 1215561683 | Rachel Denton | Social Worker | 151 E 5600 S Ste 308, Murray, UT 84107-8102 | 2020-02-25 |
| 1487294252 | Judicial Supervision Services, LLC | Social Worker | 5047 S Galleria Dr, Murray, UT 84123-4695 | 2020-01-09 |
| 1245888593 | Inner Purpose Counseling, LLC | Social Worker | 5802 S 900 E Ste 4, Murray, UT 84121-1644 | 2019-08-29 |
| 1477046662 | Aubree Payne | Social Worker | 348 E 4500 S Ste 360, Murray, UT 84107-3920 | 2018-06-12 |
| 1134616899 | Kaizen Center for Mental Health Pllc | Social Worker | 4055 S 700 E Ste 103, Murray, UT 84107-2508 | 2018-04-18 |
| 1295243251 | Shannon M Hickman | Social Worker | 111 E 5600 S Ste 210, Murray, UT 84107-8160 | 2018-01-11 |
| 1548774896 | Robert M Carboni | Social Worker | 5402 S Willow Ln Apt A, Murray, UT 84107-3403 | 2017-11-24 |
| 1043762420 | Sloane Rampton | Social Worker | 4848 S Commerce Dr, Murray, UT 84107-4761 | 2016-11-01 |
| 1679028765 | Lindy Snell Christensen | Social Worker | 650 E 4500 S Ste 300, Murray, UT 84107-4502 | 2016-08-18 |
| Find all providers in MURRAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.