Provider Demographics
NPI:1184177750
Name:HARPER, JAKE (MS)
Entity type:Individual
Prefix:
First Name:JAKE
Middle Name:
Last Name:HARPER
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:JACOB
Other - Middle Name:
Other - Last Name:HARPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:578 E 300 S
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-3831
Mailing Address - Country:US
Mailing Address - Phone:801-763-5010
Mailing Address - Fax:
Practice Address - Street 1:578 E 300 S
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-3831
Practice Address - Country:US
Practice Address - Phone:801-763-5010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-29
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG60661734251S00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No251S00000XAgenciesCommunity/Behavioral Health