Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacob K Vickrey, LCSW

Individual provider Clinical Social Worker · NPI 1053889501

Jacob K Vickrey, LCSW is a Clinical Social Worker in South Jordan, Utah. Practices as a sole proprietor. Licensed in Utah.

Licensed in
UT
In the registry since
2018
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

11748 S 3600 W Ste 3
South Jordan, UT 84095-5922
Phone: (801) 896-8133
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 9742056-3501 (UT)

Record details

NPI number1053889501
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedNovember 2, 2018
Last updated in NPPESAugust 16, 2024
Certification dateAugust 16, 2024

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