Individual
MARK JARDINE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1020 S MAIN ST, SUITE 300, SALT LAKE CITY, UT 84101-3176
(801) 536-6523
(801) 536-6520
Mailing address
2629 STRINGHAM AVE, APT. B310, SALT LAKE CITY, UT 84109-3967
(801) 487-0309
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
911331923501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107001377101
INTERMOUNTAIN HEALTH CARE
UT
01
—
261909
DESERET MUTUAL
UT
01
—
942938348JA3
EDUCATORS MUTUAL
UT
01
—
S56117
MEDICARE ADVANTAGE PLANS
UT
Enumeration date
02/13/2006
Last updated
07/09/2007
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