Healthcare Provider Details

I. General information

NPI: 1952645236
Provider Name (Legal Business Name): NATHAN ADAM SAUTER CSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2012
Last Update Date: 01/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 E 100 S
PRICE UT
84501-3102
US

IV. Provider business mailing address

575 E 100 S
PRICE UT
84501-3102
US

V. Phone/Fax

Practice location:
  • Phone: 435-637-2358
  • Fax: 435-637-9141
Mailing address:
  • Phone: 435-637-2358
  • Fax: 435-637-9141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8014302-3502
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: