Davis, Derek Paul

Davis, Derek Paul is an individual health care provider with primary practice located at 1300 E Center St , Provo UT 84606-3554. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Davis, Derek Paul can be contacted via phone (801) 344-4215.

Contact Information

Primary practice address
1300 E Center St Provo UT 84606-3554
Phone: (801) 344-4215
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 139877-3501 Utah

Profile Details

NPI number 1386624625
LBN Legal business name Davis, Derek Paul
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 20th, 2006
Last updated Jun 28th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386624625 NPPES
Utah Other 107001373101 INTERMOUNTAIN HEALTH CARE
Utah Other 261878 INTERMOUNTAIN HEALTH CARE
Utah Other 942938348DAV INTERMOUNTAIN HEALTH CARE
Utah Other 942938348 INTERMOUNTAIN HEALTH CARE

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