Provider Demographics
NPI:1194227793
Name:POWELL, JARED NATHANIEL (LCSW, MSW, JD)
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:NATHANIEL
Last Name:POWELL
Suffix:
Gender:M
Credentials:LCSW, MSW, JD
Other - Prefix:
Other - First Name:SOMATIC TRAUMA THERA
Other - Middle Name:
Other - Last Name:JARED N POWELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9917 S TEE BOX DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84009-9776
Mailing Address - Country:US
Mailing Address - Phone:949-422-3775
Mailing Address - Fax:801-876-5375
Practice Address - Street 1:8537 S REDWOOD RD STE C1
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-4806
Practice Address - Country:US
Practice Address - Phone:949-422-3775
Practice Address - Fax:801-876-5375
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-28
Last Update Date:2025-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10239101-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical