Healthcare Provider Details

I. General information

NPI: 1134593387
Provider Name (Legal Business Name): DARIN RASMUSSEN LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2015
Last Update Date: 03/08/2022
Certification Date: 02/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 S STATE ST STE E1
OREM UT
84058-6347
US

IV. Provider business mailing address

550 AARON AVE
SPRINGVILLE UT
84663-1542
US

V. Phone/Fax

Practice location:
  • Phone: 801-252-5374
  • Fax:
Mailing address:
  • Phone: 801-615-9722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11168103-3501
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: