Healthcare Provider Details

I. General information

NPI: 1639576556
Provider Name (Legal Business Name): ERIK JENKINS LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2014
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

537 W 2600 S STE 200
BOUNTIFUL UT
84010-7780
US

IV. Provider business mailing address

124 W WENDELL WAY
FARMINGTON UT
84025-5084
US

V. Phone/Fax

Practice location:
  • Phone: 801-663-8575
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8320035-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: