MEDICARE: STEFAN EDWARD STRICKHOLM MFCC

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	106H00000X	Marriage & Family Therapist	13613	CA

General Provider Information

NPI Number	:	1891648515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEFAN EDWARD STRICKHOLM MFCC

Provider Business Mailing Address
First Line	:	570 S 300 W UNIT S611
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84101-2673
Country	:	US
Telephone Number	:	805-569-5933
Fax Number	:

Provider Business Practice Location Address
First Line	:	570 S 300 W UNIT S611
Second Line	:
City	:	SALT LAKE CTY
State	:	UT
Zip	:	84101-2673
Country	:	US
Telephone Number	:	805-452-4533
Fax Number	:

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

Provider Enumeration Date	:	02/20/2026
Last Update Date	:	02/23/2026

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