Jeremiah Southworth - Provo, UT

Jeremiah Southworth

Mental Health Counselor in Provo, Utah

NPI 1104223593

Jeremiah Southworth is a Mental Health Counselor based in Provo, UT and is specialized in Mental Health. Jeremiah Southworth practices in Provo, UT. The NPI Number for Jeremiah Southworth is 1104223593 and holds a License No. (Utah).

The current practice location address for Jeremiah Southworth is 750 N Freedom Blvd, Provo, UT and can be reached out via phone at 801-373-4760 and via fax at 801-373-0639.

Location: 750 N Freedom Blvd, Provo, UT, 84601-1677

NPI Number

1104223593

Provider Name

Jeremiah Southworth

Credential

Provider Entity Type

Individual

Gender

Male

Address

750 N Freedom Blvd, Provo, UT, 84601-1677

Phone Number

801-373-4760

Fax Number

801-373-0639

Provider Enumeration Date

12/01/2014

Last Update Date

03/09/2024

Address

750 N Freedom Blvd

City

Provo

State

Utah

Zip

84601-1677

Phone Number

801-373-4760

Fax Number

801-373-0639

Address

750 N Freedom Blvd

City

Provo

State

Utah

Zip

84601-1677

Phone Number

801-373-4760

Fax Number

801-373-0639

Type

Behavioral Health & Social Service Providers

Classification

Counselor

Speciality

Mental Health

Taxonomy

101YM0800X

License No.

()

Definition

Definition to come...

Type

Other Service Providers

Classification

Peer Specialist

Speciality

Taxonomy

175T00000X

License No.

()

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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