Provider Demographics
NPI:1679003453
Name:CLEMENTS, STEVEN CHRISTOPHER (CSW)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:CHRISTOPHER
Last Name:CLEMENTS
Suffix:
Gender:M
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7878 N RED RIVER DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE MOUNTAIN
Mailing Address - State:UT
Mailing Address - Zip Code:84005-7226
Mailing Address - Country:US
Mailing Address - Phone:801-592-9016
Mailing Address - Fax:
Practice Address - Street 1:2872 S HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-3147
Practice Address - Country:US
Practice Address - Phone:891-485-8051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-14
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical