MEDICARE: ALINA OLSEN SCHMELZER LCSW

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
1	1041C0700X	Clinical Social Worker	6192427-3501	UT

General Provider Information

NPI Number	:	1235694589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALINA OLSEN SCHMELZER LCSW

Provider Business Mailing Address
First Line	:	2250 E PHEASANT WAY
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-1313
Country	:	US
Telephone Number	:	513-519-0978
Fax Number	:

Provider Business Practice Location Address
First Line	:	4527 S 2300 E STE 206
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-4446
Country	:	US
Telephone Number	:	801-609-8351
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2019
Last Update Date	:	01/31/2019

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