Natalie Nicole Clark

Individual provider Active NPI Clinical Social Worker · South Salt Lake, UT

NPI 1689458713 · NPPES record last updated Aug 21, 2023

Key facts

NPI
1689458713
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
1831485184 (UT)
Practice address
177 W Price Ave
South Salt Lake, UT 84115-4345
Phone
(385) 468-4500
NPI assigned
Aug 21, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1831485184UTMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1831485184 UT Yes

Addresses

Primary practice location

177 W Price Ave
South Salt Lake, UT 84115-4345

Mailing address

1124 E Browning Ave
Salt Lake City, UT 84105-2524
Phone (801) 854-8093

Other providers in South Salt Lake, UT

All providers in South Salt Lake, UT · Clinical Social Worker in Utah

Sources for this page

Verify at the official NPI Registry.