MEDICARE: KEELEY JEAN MENDENHALL

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
1	104100000X	Social Worker	5733523-3502	UT

General Provider Information

NPI Number	:	1588801401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEELEY JEAN MENDENHALL

Provider Business Mailing Address
First Line	:	675 E. 500 S.
Second Line	:	STE 300
City	:	SLC
State	:	UT
Zip	:	84102
Country	:	US
Telephone Number	:	801-662-3606
Fax Number	:

Provider Business Practice Location Address
First Line	:	675 E 500 S
Second Line	:	STE 300
City	:	SLC
State	:	UT
Zip	:	84102-2818
Country	:	US
Telephone Number	:	801-662-3606
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2009
Last Update Date	:	01/14/2009

Similar Medicare Providers

1386983740 — AUTISM JOURNEYS TREATMENT CENTER
Practice Location Address:

675 E 500 S , SUITE 360
SALT LAKE CITY, UT
84102-2818

Practice Phone: 801-938-9268
Practice Fax: 801-572-7460

1245672880 — MR. HOWARD FRANKLIN DAHLE MS, CMHC
Practice Location Address:

675 E 500 S
SALT LAKE CITY, UT
84102-2818

Practice Phone: 801-938-9268
Practice Fax:

1790779106 — DR. BONNIE J LEE M.D.
Practice Location Address:

554 S 800 E
SLC, UT
84102-2931

Practice Phone: 801-557-4595
Practice Fax: 801-596-8080

1427023571 — YONG HUI AHN MD
Practice Location Address:

24 S 1100 E STE 310
SLC, UT
84102-1500

Practice Phone: 801-328-1260
Practice Fax: 801-350-4361

1790745248 — DR. SAM GOLDSTEIN PH.D.
Practice Location Address:

230 S 500 E , SUITE 100
SLC, UT
84102-2015

Practice Phone: 801-532-1484
Practice Fax: 801-532-1486

1326002437 — MR. MATTHEW G. LARSON LCSW
Practice Location Address:

24 S 600 E , STE. 6
SLC, UT
84102

Practice Phone: 801-599-6396
Practice Fax: 801-521-0688

Directions to “ KEELEY JEAN MENDENHALL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.