Provider Demographics
NPI:1801086723
Name:MCGAW, JANNA MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:JANNA
Middle Name:MARIE
Last Name:MCGAW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1399 S 700 E
Mailing Address - Street 2:11B
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-2149
Mailing Address - Country:US
Mailing Address - Phone:801-792-3802
Mailing Address - Fax:435-645-9409
Practice Address - Street 1:265 LOWER EVERGREEN DR
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-5254
Practice Address - Country:US
Practice Address - Phone:801-792-3802
Practice Address - Fax:435-645-9409
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT286085-3501101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health