Healthcare Provider Details

I. General information

NPI: 1265051403
Provider Name (Legal Business Name): BLUE SKIES COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2020
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13073 S KEEGAN DR
HERRIMAN UT
84096-2657
US

IV. Provider business mailing address

5524 W 13400 S # 521
HERRIMAN UT
84096-6919
US

V. Phone/Fax

Practice location:
  • Phone: 801-413-3740
  • Fax: 801-931-2173
Mailing address:
  • Phone: 801-413-3740
  • Fax: 801-931-2173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JAYNE ANN SUMNER
Title or Position: THERAPIST/OWNER
Credential: LCSW
Phone: 801-413-3740