Provider Demographics
NPI:1952119711
Name:SWENSEN, CLAYTON THOMAS
Entity type:Individual
Prefix:
First Name:CLAYTON
Middle Name:THOMAS
Last Name:SWENSEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 64
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-0064
Mailing Address - Country:US
Mailing Address - Phone:801-878-4220
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 64
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084-0064
Practice Address - Country:US
Practice Address - Phone:801-878-4220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-26
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health