Provider Demographics
NPI:1073340188
Name:ACKERMAN, NATALIE (CSW)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:ACKERMAN
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12523 S PASTURE RD STE 250
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84096-4842
Mailing Address - Country:US
Mailing Address - Phone:801-796-2039
Mailing Address - Fax:
Practice Address - Street 1:12523 S PASTURE RD STE 250
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84096-4842
Practice Address - Country:US
Practice Address - Phone:801-796-2039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-14
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13002857-3502104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker