| Jordan West Family Counseling Inc | |
|
9263b Redwood Rd West Jordan UT 84088 | |
| (801) 566-0749 | |
| (801) 566-7108 |
| Full Name | Jordan West Family Counseling Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9263b Redwood Rd, West Jordan, Utah |
| Authorized Official Name and Position | Betty J. Owen (CLINICAL DIRECTOR) |
| Authorized Official Contact | 8015660749 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jordan West Family Counseling Inc 9263b Redwood Rd West Jordan UT 84088-6571 Ph: (801) 566-0749 | Jordan West Family Counseling Inc 9263b Redwood Rd West Jordan UT 84088 Ph: (801) 566-0749 |
| NPI Number | 1508811480 |
|---|---|
| Provider Enumeration Date | 05/22/2006 |
| Last Update Date | 06/19/2018 |
| Medicare PECOS PAC ID | 4688629439 |
|---|---|
| Medicare Enrollment ID | O20050315000598 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508811480 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 52044 (Utah) | Primary |
| Provider Name | Betty Owen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295877512 PECOS PAC ID: 3375533656 Enrollment ID: I20040518000089 |
| Provider Name | Kendall G Lowe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558306506 PECOS PAC ID: 6608847678 Enrollment ID: I20040806001055 |
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