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Individual

MRS. JENNIFER POULOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW, LSUDC

Contact information

Practice address
1412 S LEGEND HILLS DR STE 334, CLEARFIELD, UT 84015-1592
(801) 608-9966
Mailing address
131 E 2600 S, CLEARFIELD, UT 84015-1951
(801) 608-9966

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
8139526-6006
UT
1041C0700X
Clinical Social Worker
Primary
8139526-3501
UT
1041C0700X
Clinical Social Worker
8139526-3506
UT

Other

Enumeration date
02/25/2011
Last updated
03/26/2026
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