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NPI Code Detail

MEDICARE: MS. JENNIFER LORRAINE NAVARRO CMHC, ASUDC

MEDICARE: MS. JENNIFER LORRAINE NAVARRO CMHC, ASUDC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor12751109-6008UT
2101YP2500XProfessional Counselor12751109-6004UT

General Provider Information

NPI Number : 1568356624
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER LORRAINE NAVARRO CMHC, ASUDC
Provider Business Mailing Address
First Line : 3903 MEDICAL DR STE 300
Second Line :
City : OGDEN
State : UT
Zip : 84403-2317
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3903 MEDICAL DR STE 300
Second Line :
City : OGDEN
State : UT
Zip : 84403-2317
Country : US
Telephone Number : 801-387-5600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2025
Last Update Date : 06/04/2025

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