JACK KETTERING (NPI# 1043516925) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1043516925 |
Entity Type | Individual |
Full Name | JACK KETTERING |
Credential | MA |
Practice Address |
930 W Hill Field Rd A Layton UT 84041-4662 |
Mailing Address |
899 Carter Dr Riverdale UT 84405-2630 |
Practice Telephone | 8013663040 |
Mailing Telephone | 4805430038 |
Enumeration Date | 2011-02-09 |
Last Update Date | 2013-10-14 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
Street Address |
930 W HILL FIELD RD A |
City | LAYTON |
State | UT |
Zip Code | 84041-4662 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639119548 | John Thomas Hill | Marriage & Family Therapist | 930 W Hill Field Rd, Suite A, Layton, UT 84041-4662 | 2006-06-08 |
1184223083 | Daniel Stuart | Marriage & Family Therapist | 930 W Hill Field Rd, Layton, UT 84041-4662 | 2020-10-21 |
1851999247 | Courtnie Christiansen | Student in an Organized Health Care Education/Training Program | 930 W Hill Field Rd, Layton, UT 84041-4662 | 2020-10-16 |
1922653567 | Marisa Wall | Social Worker | 930 W Hill Field Rd, Layton, UT 84041-4662 | 2019-08-08 |
1891251021 | Lesley Anne De La Torre | Counselor | 930 W Hill Field Rd, Layton, UT 84041-4662 | 2019-02-12 |
1215416052 | Rachel Garner | Counselor | 930 W Hill Field Rd, Layton, UT 84041-4662 | 2018-08-13 |
1912420894 | Linda S Wininger | Social Worker | 930 W Hill Field Rd, Layton, UT 84041-4662 | 2017-07-21 |
1881822716 | Blaine Reuben Hickman | Social Worker | 930 W Hill Field Rd, #a, Layton, UT 84041-4662 | 2009-06-30 |
1447492301 | Bryan Lowell Nielsen | Counselor | 930 W Hill Field Rd, Suite A, Layton, UT 84041-4662 | 2009-03-24 |
1467672675 | David Lorin Pitcher | Social Worker | 930 W Hill Field Rd, Suite A, Layton, UT 84041-4662 | 2007-04-27 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700499183 | Grab Healthcare, LLC | Clinic/Center | 245 E 2150 N, Suite C, Layton, UT 84041 | 2020-08-26 |
1154961399 | Victoria Leeann Taylor | Massage Therapist | 716 Antelope Dr, Layton, UT 84041 | 2020-01-15 |
1184181505 | Brian Taylor Woodbury | Occupational Therapist | 471 Heritage Park Blvd. Ste #5, Layton, UT 84041 | 2019-02-21 |
1740756816 | Jacob C Juarez | Physician Assistant | 2084 N. 1700 W., Suite A, Layton, UT 84041 | 2018-10-16 |
1134637945 | Jodi Lynn Siri | Counselor | 365 W 1550 N Ste F, Layton, UT 84041 | 2018-01-15 |
1083128029 | Utah Cvs Pharmacy LLC | Pharmacy | 50 South Fort Lane, Layton, UT 84041 | 2017-11-29 |
1376057315 | Utah Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2000 W & W 1700 S Nec, Layton, UT 84041 | 2017-11-29 |
1912411992 | Live Strong House LLC | Counselor | 377 N. Marshall Way, Suite 1b, Layton, UT 84041 | 2017-11-28 |
1003326505 | Kenneth L Ernstrom | Pharmacist | 2065 N Robins Drive, Layton, UT 84041 | 2017-10-10 |
1356868319 | Utah Home Health and Hospice LLC | Family Medicine | 920 W Heritage Park Blvd Suite 120, Layton, UT 84041 | 2017-08-29 |
Find all providers in zip 84041 |
Taxonomy Code | 101YM0800X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790328102 | Dylan L Redd | Counselor | 476 Heritage Park Blvd, Layton, UT 84041-5713 | 2019-10-18 |
1508362195 | Nicholas Ian Mathis | Counselor | 327 W Gordon Ave Ste 1, Layton, UT 84041-2381 | 2018-04-03 |
1134637945 | Jodi Lynn Siri | Counselor | 365 W 1550 N Ste F, Layton, UT 84041 | 2018-01-15 |
1093232324 | Alyson Gardner | Counselor | 327 W Gordon Ave # 1, Layton, UT 84041-2377 | 2017-08-28 |
1720537210 | Dena Letendre | Counselor | 3067 W 350 N, Layton, UT 84041-8816 | 2016-09-26 |
1205223849 | Damon Christopher Corgiat | Counselor | 1916 Layton Hills Pkwy, Suite 190, Layton, UT 84041-5673 | 2015-04-21 |
1598157489 | Dina Hargrave | Counselor | 327 W Gordon Ave Ste 2, Layton, UT 84041-2381 | 2015-03-02 |
1154729317 | Outlook Counseling Services, Pllc | Counselor | 2621 Oak Hills Dr, Layton, UT 84040-7526 | 2014-12-19 |
1538575659 | Wendy Foster | Counselor | 2363 North Hillfield Rd., Ste #6, Layton, UT 84041 | 2014-07-09 |
1013328103 | Melanie Richardson | Counselor | 2363 N Hill Field Rd Ste 6, Layton, UT 84041-6958 | 2014-05-12 |
Find all providers in LAYTON |
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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.