Provider Demographics
NPI:1194227793
Name:POWELL, JARED NATHANIEL (CSW, MSW, JD)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:NATHANIEL
Last Name:POWELL
Suffix:
Gender:M
Credentials:CSW, MSW, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COMPREHENSIVE PSYCHOLOGICAL SERVICES
Mailing Address - Street 2:1208 3300 S
Mailing Address - City:MILLCREEK
Mailing Address - State:UT
Mailing Address - Zip Code:84106
Mailing Address - Country:US
Mailing Address - Phone:801-483-1600
Mailing Address - Fax:
Practice Address - Street 1:FIRST STEP HOUSE
Practice Address - Street 2:440 S 500 E
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-2705
Practice Address - Country:US
Practice Address - Phone:801-359-8862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10239101-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical