Healthcare Provider Details

I. General information

NPI: 1427455823
Provider Name (Legal Business Name): JAMESON AHERN LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2014
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1057 E 400 S
SALT LAKE CITY UT
84102-3114
US

IV. Provider business mailing address

1057 E 400 S
SALT LAKE CITY UT
84102-3114
US

V. Phone/Fax

Practice location:
  • Phone: 801-503-2986
  • Fax:
Mailing address:
  • Phone: 801-503-2986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7891864-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: