Provider Demographics
NPI:1467731968
Name:MATHEWS, DANIEL KADE (LCSW)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:KADE
Last Name:MATHEWS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:DANIEL
Other - Middle Name:KADE
Other - Last Name:MATHEWS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:168 N 100 E STE 210
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-3937
Mailing Address - Country:US
Mailing Address - Phone:435-703-3076
Mailing Address - Fax:
Practice Address - Street 1:168 N 100 E STE 210
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-3937
Practice Address - Country:US
Practice Address - Phone:435-703-3076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-15
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6215019-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical