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Individual

NATHAN VAN DYKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1425 S 700 E STE 102, SALT LAKE CITY, UT 84105-2125
(801) 448-7577
Mailing address
433 W 2ND AVE, MIDVALE, UT 84047-7307
(801) 577-8869

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
9148081-6005
UT
101YA0400X
Addiction (Substance Use Disorder) Counselor
9148081-6006
UT
1041C0700X
Clinical Social Worker
Primary
9148081-3501
UT

Other

Enumeration date
07/01/2015
Last updated
01/29/2026
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