Provider Demographics
NPI:1407300379
Name:BARTON, DREW KAPONO (LCSW)
Entity Type:Individual
Prefix:
First Name:DREW
Middle Name:KAPONO
Last Name:BARTON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6967 S RIVERGATE DRIVE
Mailing Address - Street 2:#100
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-1575
Mailing Address - Country:US
Mailing Address - Phone:801-565-1162
Mailing Address - Fax:801-565-1168
Practice Address - Street 1:9071 S 1300 W STE 301
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-6675
Practice Address - Country:US
Practice Address - Phone:801-565-1162
Practice Address - Fax:801-565-1168
Is Sole Proprietor?:No
Enumeration Date:2016-08-09
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTHT002258-001Medicaid