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General NPI Number Information
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NPI Number | 1194227793
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Entity Type | Individual
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Provider Name | JARED NATHANIEL POWELL LCSW, MSW, JD
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Gender | Male
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Dates
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Enumeration Date | 02/28/2018
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Last Update Date | 10/18/2025
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Provider Practice Location Address
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Address Line | 8537 S REDWOOD RD STE C1
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City | WEST JORDAN
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State | UT
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Zip | 84088-4806
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Country | US
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Telephone | 949-422-3775
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Fax | 801-876-5375
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Provider Business Mailing Address
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Address Line | 9917 S TEE BOX DR
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City | SOUTH JORDAN
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State | UT
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Zip | 84009-9776
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Country | US
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Telephone | 949-422-3775
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Fax | 801-876-5375
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10239101-3501
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License Number State | UT
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