Provider Demographics
NPI:1881211506
Name:LAMONT, JENNIFER ELAINE (MSW, CSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ELAINE
Last Name:LAMONT
Suffix:
Gender:F
Credentials:MSW, CSW
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:ELAINE
Other - Last Name:LARSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:PO BOX 520009
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84152-0009
Mailing Address - Country:US
Mailing Address - Phone:801-281-1100
Mailing Address - Fax:801-281-1936
Practice Address - Street 1:716 E 4500 S STE N160
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-3617
Practice Address - Country:US
Practice Address - Phone:801-281-1100
Practice Address - Fax:801-281-1936
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT378097-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical