Provider Demographics
NPI:1902101587
Name:JONES, BENJAMIN DEAN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:DEAN
Last Name:JONES
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 1:4682 EAST FOXWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:EAGLE MOUNTAIN
Mailing Address - State:UT
Mailing Address - Zip Code:84005
Mailing Address - Country:US
Mailing Address - Phone:801-609-4396
Mailing Address - Fax:801-465-8005
Practice Address - Street 1:4682 EAST FOXWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:EAGLE MOUNTAIN
Practice Address - State:UT
Practice Address - Zip Code:84005
Practice Address - Country:US
Practice Address - Phone:801-609-4396
Practice Address - Fax:801-465-8005
Is Sole Proprietor?:No
Enumeration Date:2011-01-13
Last Update Date:2013-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7760548-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical