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JEREMIAH SOUTHWORTH
NPI 1104223593
Counselor - Mental Health in Provo, UT

Active since December 01, 2014
750 N FREEDOM BLVD, PROVO, UT 84601(801) 373-4760(801) 373-0639 Get Directions Write a Review

NPPES record last updated: May 7, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jeremiah Southworth NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEREMIAH SOUTHWORTH (NPI 1104223593) is an individual mental health provider in Provo, Utah and active in the NPI registry since December 2014.

NPPES Registry Identity

NPI1104223593
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameJEREMIAH SOUTHWORTH
Location Address750 N FREEDOM BLVDProvo, UT 84601-1677
Mailing Address750 N Freedom BlvdProvo, UT 84601-1677 · (801) 373-4760 · Fax (801) 373-0639
Phone(801) 373-4760
Fax(801) 373-0639
Sole ProprietorYes
Enumeration DateDecember 1, 2014
Last NPPES UpdateMay 7, 2020
NPPES CertifiedMay 7, 2020
✔ NPI 1104223593 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Also ListedPeer SpecialistTaxonomy 175T00000X
750 N FREEDOM BLVD, Provo, UT 84601
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELIZA RACHELLE GEDGE PH.D., LP
Psychologist (Clinical)
750 N FREEDOM BLVD
PROVO, UT 84601
Utah County (801) 373-0639
WASATCH MENTAL HEALTH
Clinic/Center (Adolescent and Children Mental Health)
750 N FREEDOM BLVD
PROVO, UT 84601
Utah County (801) 373-4760
JUSTINE CADAYONG EGGLESTON
Social Worker (Clinical)
750 N FREEDOM BLVD
PROVO, UT 84601
Utah County (801) 373-4760
SARAH FARIA
Case Manager/Care Coordinator
750 N FREEDOM BLVD
PROVO, UT 84601
Utah County (801) 373-4760
MEGAN NICHOLS
Case Manager/Care Coordinator
750 N FREEDOM BLVD
PROVO, UT 84601
Utah County (801) 373-4760
VICTORIA RYALS
Student in an Organized Health Care Education/Training Program
750 N FREEDOM BLVD
PROVO, UT 84601
Utah County (801) 373-4760
KAMERYA HANOHANO
Peer Specialist
750 N FREEDOM BLVD
PROVO, UT 84601
Utah County (801) 373-4760
ALLISON RAMIREZ
Peer Specialist
750 N FREEDOM BLVD
PROVO, UT 84601
Utah County (801) 373-4760

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeremiah Southworth's NPI number?

The NPI number for Jeremiah Southworth is 1104223593. It was assigned to this individual provider in the NPPES registry on December 1, 2014.

Where is Jeremiah Southworth located?

Jeremiah Southworth practices at 750 N Freedom Blvd, Provo, UT 84601. The listed phone number is (801) 373-4760.

What is Jeremiah Southworth's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Jeremiah Southworth was last updated on May 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.