Provider Demographics
NPI:1962939629
Name:STRONG, JOHNATHAN COLBEY (LCSW)
Entity type:Individual
Prefix:
First Name:JOHNATHAN
Middle Name:COLBEY
Last Name:STRONG
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5239 W BRIDLE HOLLOW PL
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84081-3965
Mailing Address - Country:US
Mailing Address - Phone:385-479-5395
Mailing Address - Fax:
Practice Address - Street 1:10694 S RIVER FRONT PKWY
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-3525
Practice Address - Country:US
Practice Address - Phone:385-479-5395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-12
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
UT7999048-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical