Provider Demographics
NPI:1003572918
Name:GARETS, MITCHELL JEFFREY (CSW)
Entity Type:Individual
Prefix:
First Name:MITCHELL
Middle Name:JEFFREY
Last Name:GARETS
Suffix:
Gender:M
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 S SUNSET VIEW DR
Mailing Address - Street 2:
Mailing Address - City:MILLCREEK
Mailing Address - State:UT
Mailing Address - Zip Code:84124-3251
Mailing Address - Country:US
Mailing Address - Phone:801-599-9781
Mailing Address - Fax:
Practice Address - Street 1:47 W 9000 S STE 1
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-2043
Practice Address - Country:US
Practice Address - Phone:801-792-1150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12343304-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical