Provider Demographics
NPI:1659591584
Name:STEINECKERT, JAY LYNN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAY
Middle Name:LYNN
Last Name:STEINECKERT
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 1:9847 N MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILLS
Mailing Address - State:UT
Mailing Address - Zip Code:84062-9431
Mailing Address - Country:US
Mailing Address - Phone:801-772-0686
Mailing Address - Fax:801-772-0468
Practice Address - Street 1:165 W CANYON CREST RD
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:UT
Practice Address - Zip Code:84004-1645
Practice Address - Country:US
Practice Address - Phone:801-772-0686
Practice Address - Fax:801-772-0468
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT124998-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical