MEDICARE: JOHN KENT GRIFFITHS DSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	112462-3501	UT
2	106H00000X	Marriage & Family Therapist	112462-3902	UT

General Provider Information

NPI Number	:	1841374600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN KENT GRIFFITHS DSW

Provider Business Mailing Address
First Line	:	4885 S 900 E STE 212
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-3913
Country	:	US
Telephone Number	:	801-268-6558
Fax Number	:

Provider Business Practice Location Address
First Line	:	4885 S 900 E STE 212
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-3913
Country	:	US
Telephone Number	:	801-268-6558
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	09/11/2025

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