Provider Demographics
NPI:1396066221
Name:VOIGT, JONATHAN (MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:
Last Name:VOIGT
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:668 N 450 E
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-4121
Mailing Address - Country:US
Mailing Address - Phone:801-367-8643
Mailing Address - Fax:
Practice Address - Street 1:5150 S WASHINGTON BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:SOUTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405-4506
Practice Address - Country:US
Practice Address - Phone:801-337-0067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT662681735011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical