Provider Demographics
NPI:1255540977
Name:CLAUSON, JOSHUA G (PSYD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:G
Last Name:CLAUSON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:699 E SOUTH TEMPLE
Mailing Address - Street 2:STE 120
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-4242
Mailing Address - Country:US
Mailing Address - Phone:801-419-0401
Mailing Address - Fax:801-350-9582
Practice Address - Street 1:699 E SOUTH TEMPLE
Practice Address - Street 2:STE 120
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-4242
Practice Address - Country:US
Practice Address - Phone:801-419-0401
Practice Address - Fax:801-350-9582
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7634974-2501103TC0700X
WY443103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY124216400Medicaid