JACKSON PATRICK COLLINS (NPI# 1912412867) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912412867 |
| Entity Type | Individual |
| Full Name | JACKSON PATRICK COLLINS |
| Practice Address |
1650 E 6670 S Salt Lake City UT 84121-2760 |
| Mailing Address |
4460 S Highland Dr Salt Lake City UT 84124-3543 |
| Practice Telephone | 8016357458 |
| Enumeration Date | 2017-12-13 |
| Last Update Date | 2017-12-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
1650 E 6670 S |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84121-2760 |
| 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 | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780281519 | Sitti Suhardi | Counselor | 2550 S Main St Apt 1307, Salt Lake City, UT 84115-3071 | 2020-10-05 |
| 1801400015 | Tyra Mae Vance | Counselor | 3375 S 880 E, Salt Lake City, UT 84106 | 2020-09-04 |
| 1033721394 | Salt Lake Therapy Collective | Counselor | 311 S 900 E Ste 103, Salt Lake City, UT 84102-2491 | 2020-08-18 |
| 1083172704 | Brooke Pyper | Counselor | 335 W Bugatti Dr, Salt Lake City, UT 84115-2521 | 2019-03-12 |
| 1881168185 | Korilynn Cheatham Bartley | Counselor | 124 S 400 E Ste 300, Salt Lake City, UT 84111-5307 | 2019-01-20 |
| 1164910089 | Gerald Louis Costley | Counselor | 339 E 3900 S Ste 155, Salt Lake City, UT 84107-1978 | 2018-04-26 |
| 1891225678 | Phil Edward Francis | Counselor | 4000 S 700 E Ste 9, Salt Lake City, UT 84107-2581 | 2017-06-14 |
| 1063866549 | Dustin Palmer | Counselor | 344 E 100 S # 230, Salt Lake City, UT 84111 | 2016-04-20 |
| 1740642735 | Misty Tae Ungricht | Counselor | 4460 S Highland Dr Ste 2106b, Salt Lake City, UT 84124-3543 | 2016-03-28 |
| 1033581723 | Christopher Lee Fiagle | Counselor | 2100 S State Street, S2-300, Salt Lake City, UT 84114-4575 | 2015-10-21 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84121 |
Please comment or provide details below to improve the information on JACKSON PATRICK COLLINS.
| 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.