Provider Demographics
NPI:1285510842
Name:HUBBARD, JUSTIN (MSW-I)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:HUBBARD
Suffix:
Gender:M
Credentials:MSW-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 B ST APT 27
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84103-3683
Mailing Address - Country:US
Mailing Address - Phone:208-815-0242
Mailing Address - Fax:
Practice Address - Street 1:331 S RIO GRANDE ST STE 200
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84101-1137
Practice Address - Country:US
Practice Address - Phone:801-485-8051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker