Healthcare Provider Details

I. General information

NPI: 1972019859
Provider Name (Legal Business Name): JONATHAN NASH CMHC, LCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JONATHAN PAUL NASH CMHC, LCPC

II. Dates (important events)

Enumeration Date: 12/14/2017
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 E 13TH ST
BURLEY ID
83318-1808
US

IV. Provider business mailing address

1469 N 1200 W
OREM UT
84057-2449
US

V. Phone/Fax

Practice location:
  • Phone: 801-655-5450
  • Fax: 385-225-9327
Mailing address:
  • Phone: 801-655-5450
  • Fax: 385-225-9327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC10003231
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH25151
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLCPC-10514
License Number StateID
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC015083
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11558-125
License Number StateWI
# 6
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11412282-6004
License Number StateUT
# 7
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCCC.CL.61608964
License Number StateWA
# 8
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0021371
License Number StateCO
# 9
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-23511
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: