Healthcare Provider Details

I. General information

NPI: 1982518866
Provider Name (Legal Business Name): SIDNEY JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2308 E 830 S UNIT 22
SPANISH FORK UT
84660-5402
US

IV. Provider business mailing address

2308 E 830 S UNIT 22
SPANISH FORK UT
84660-5402
US

V. Phone/Fax

Practice location:
  • Phone: 801-512-7504
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number12393782-6006
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: