Healthcare Provider Details

I. General information

NPI: 1437498565
Provider Name (Legal Business Name): NATHANIEL RAY SWAPP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2013
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 W 1850 N
PROVO UT
84604
US

IV. Provider business mailing address

388 W CENTER ST
OREM UT
84057-4659
US

V. Phone/Fax

Practice location:
  • Phone: 801-375-4240
  • Fax: 801-375-4241
Mailing address:
  • Phone: 801-960-3131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10126079-3501
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: