Provider Demographics
NPI:1366413627
Name:SHERMAN, JONATHAN DANIEL (LMFT)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:DANIEL
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 E 230 N
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-2948
Mailing Address - Country:US
Mailing Address - Phone:801-492-3415
Mailing Address - Fax:
Practice Address - Street 1:1753 SIDEWINDER DR
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84060-7258
Practice Address - Country:US
Practice Address - Phone:435-649-8347
Practice Address - Fax:435-649-2157
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3630933902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT107032322101OtherINTERMTN. HEALTH CARE