Provider Demographics
NPI:1336633247
Name:DAY, NATALIE ANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ANNE
Last Name:DAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:772 N MAIN STREET BOX 214
Mailing Address - Street 2:
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074-1657
Mailing Address - Country:US
Mailing Address - Phone:385-519-4737
Mailing Address - Fax:
Practice Address - Street 1:352 N MAIN ST
Practice Address - Street 2:
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-1657
Practice Address - Country:US
Practice Address - Phone:385-519-4737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-37801104100000X
UT12727982-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT12727982-3501OtherDOPL
IDLCSW-41935OtherIBOL