Individual provider · Type 1 NPI

Mitchel Jay Vanwagoner, LCSW

Clinical Social Worker · South Jordan, UT

NPI number 1861056343 Active

Practice location

5048 W Duckhorn Dr
South Jordan, UT 84009-8121

Specialties and licenses

TaxonomyCodeLicense
Case Manager/Care Coordinator 171M00000XNone listed
Clinical Social Worker Primary 1041C0700X11780474-3501 (UT)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1861056343

Mitchel Jay Vanwagoner, LCSW's National Provider Identifier is 1861056343, issued on Apr 30, 2019. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in South Jordan, UT. The record was last updated on Aug 20, 2026.