Healthcare Provider Details

I. General information

NPI: 1437630159
Provider Name (Legal Business Name): MEGAN DANIELLE ANDERSON CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2018
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7625 S 3200 W STE 2&4
WEST JORDAN UT
84084-2800
US

IV. Provider business mailing address

7626 S 3200 W STE 2&4
WEST JORDAN UT
84084-2821
US

V. Phone/Fax

Practice location:
  • Phone: 801-915-0359
  • Fax:
Mailing address:
  • Phone: 801-915-0359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number18410
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12740119-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: