Basic Information
| Provider Information | |||||||||
| NPI: | 1407835218 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ASPER | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | ROBERT | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3665 BUCKEROO DR | ||||||||
| Address2: | |||||||||
| City: | MAGNA | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840442344 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8012521861 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1020 S MAIN ST | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841013176 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015397000 | ||||||||
| FaxNumber: | 8015397050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2006 | ||||||||
| LastUpdateDate: | 09/13/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 03205523501 | UT | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | P64616 | 01 | UT | MEDICARE ADVANTAGE PLANS | OTHER | 107009849101 | 01 | UT | INTERMOUNTAIN HEALTH CARE | OTHER | 004662195 | 01 | UT | RAILROAD MEDICARE | OTHER | 695320 | 01 | UT | DESERET MUTUAL | OTHER | 942938348ASP | 01 | UT | EDUCATORS MUTUAL | OTHER |