Individual
MARK DEVEN WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
327 W GORDON AVE STE 2, LAYTON, UT 84041-2381
(801) 683-1062
Mailing address
237 26TH ST, OGDEN, UT 84401-3105
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8857179-3501
UT
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000055266
MEDICARE PIN
UT
01
—
260022408
RAILROAD MEDICARE
UT
05
—
8760003008007
—
UT
Enumeration date
05/02/2018
Last updated
05/10/2023
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