Healthcare Provider Details

I. General information

NPI: 1386010437
Provider Name (Legal Business Name): JERRAH BARRETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2015
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1459 E 3900 S
SALT LAKE CITY UT
84124-1412
US

IV. Provider business mailing address

1522 S 1100 E
SALT LAKE CITY UT
84105-2425
US

V. Phone/Fax

Practice location:
  • Phone: 801-467-1200
  • Fax: 801-467-1210
Mailing address:
  • Phone: 801-467-1200
  • Fax: 801-467-1210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number124099646004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: