Provider Demographics
NPI:1992352686
Name:TUBBS, NATHAN CHRISTOPHER (LCSW)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:CHRISTOPHER
Last Name:TUBBS
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:694 N 130 E
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84335-6748
Mailing Address - Country:US
Mailing Address - Phone:801-368-1648
Mailing Address - Fax:
Practice Address - Street 1:75 W 100 S STE 100
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84321-5840
Practice Address - Country:US
Practice Address - Phone:801-368-1648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health