Provider Demographics
NPI:1346653417
Name:SAUL, JONATHAN (CMHC)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:SAUL
Suffix:
Gender:M
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 E STEEP MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-5143
Mailing Address - Country:US
Mailing Address - Phone:801-652-7339
Mailing Address - Fax:
Practice Address - Street 1:5288 S ALLENDALE DR
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84123-4536
Practice Address - Country:US
Practice Address - Phone:801-652-7339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-06
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7673583-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health