Individual
NATHAN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
3051 W MAPLE LOOP DR STE 210, LEHI, UT 84043-4602
(801) 872-5516
Mailing address
5383 S 900 E STE 103, MURRAY, UT 84117-7266
(801) 872-5516
(801) 212-9942
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11778360-3502
UT
1041C0700X
Clinical Social Worker
Primary
12256132-3506
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11778360-3502
LICENSE
UT
Enumeration date
05/23/2022
Last updated
03/31/2026
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