Individual
DOUGLAS JARED IVIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
801 E REDMAPLE RD # 1, MILLCREEK, UT 84106-1541
(503) 975-6095
Mailing address
801 E REDMAPLE RD # 1, MILLCREEK, UT 84106-1541
(503) 975-6095
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
Primary
12435975-3501
UT
Other
Enumeration date
11/03/2011
Last updated
03/17/2026
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