Healthcare Provider Details

I. General information

NPI: 1750556882
Provider Name (Legal Business Name): JENNIFER SLAUSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER SLAUSON BELTRAN LCSW

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 N 800 W
OREM UT
84057-2977
US

IV. Provider business mailing address

1415 N 800 W
OREM UT
84057-2977
US

V. Phone/Fax

Practice location:
  • Phone: 801-885-3416
  • Fax:
Mailing address:
  • Phone: 801-885-3416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7351574-3501
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: