Individual
ELIJAH KIMBALL NIELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 373-4760
Mailing address
500 FOOTHILL BLVD, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
5687052-3502
UT
1041C0700X
Clinical Social Worker
Primary
5687052-3501
UT
Other
Enumeration date
09/26/2006
Last updated
04/07/2026
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