Provider Demographics
NPI:1720498355
Name:HARMON, JORDAN KENT (LCSW)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:KENT
Last Name:HARMON
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 1:960 CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-2862
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:230 W TOWNE RIDGE PKWY
Practice Address - Street 2:STE. #225
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-2005
Practice Address - Country:US
Practice Address - Phone:801-440-2023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-05
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7392210-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical