1194227793 NPI number — JARED NATHANIEL POWELL LCSW, MSW, JD

Table of content: JARED NATHANIEL POWELL LCSW, MSW, JD (NPI 1194227793)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194227793 NPI number — JARED NATHANIEL POWELL LCSW, MSW, JD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
POWELL
Provider First Name:
JARED
Provider Middle Name:
NATHANIEL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW, MSW, JD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JARED N POWELL
Provider Other First Name:
SOMATIC TRAUMA THERAPY SLC
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1194227793
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/18/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9917 S TEE BOX DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTH JORDAN
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84009-9776
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-422-3775
Provider Business Mailing Address Fax Number:
801-876-5375

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8537 S REDWOOD RD STE C1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST JORDAN
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84088-4806
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-422-3775
Provider Business Practice Location Address Fax Number:
801-876-5375
Provider Enumeration Date:
02/28/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  10239101-3501 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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