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NPI Code Detail

MEDICARE: LEXI ELANA DIEDRICH CMHC

MEDICARE: LEXI ELANA DIEDRICH CMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor65279556004UT

General Provider Information

NPI Number : 1225262801
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEXI ELANA DIEDRICH CMHC
Provider Business Mailing Address
First Line : 4465 S 900 E STE 150
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84124-3944
Country : US
Telephone Number : 435-248-2089
Fax Number : 801-207-5104
Provider Business Practice Location Address
First Line : 4465 S 900 E STE 150
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84124-3944
Country : US
Telephone Number : 435-248-2089
Fax Number : 801-207-5104
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2009
Last Update Date : 04/15/2026

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Directions to “ LEXI ELANA DIEDRICH CMHC” Practice Location

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