Provider Demographics
NPI:1437498565
Name:SWAPP, NATHANIEL RAY
Entity type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:RAY
Last Name:SWAPP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:388 W CENTER ST
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-4659
Mailing Address - Country:US
Mailing Address - Phone:801-960-3131
Mailing Address - Fax:
Practice Address - Street 1:723 W 1850 N
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604
Practice Address - Country:US
Practice Address - Phone:801-375-4240
Practice Address - Fax:801-375-4241
Is Sole Proprietor?:No
Enumeration Date:2013-02-08
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
UT10126079-3501101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health