Healthcare Provider Details

I. General information

NPI: 1437478534
Provider Name (Legal Business Name): NATALIE L JENSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NATALIE LYNN NYLUND JENSON

II. Dates (important events)

Enumeration Date: 05/28/2010
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 E 4500 S STE 570
MURRAY UT
84107-4239
US

IV. Provider business mailing address

310 E 4500 S
MURRAY UT
84107-3993
US

V. Phone/Fax

Practice location:
  • Phone: 801-292-9619
  • Fax:
Mailing address:
  • Phone: 801-233-8670
  • Fax: 801-233-8682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6115530-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: