Healthcare Provider Details

I. General information

NPI: 1467366518
Provider Name (Legal Business Name): TAYLER DUREKAS ACMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14241 S REDWOOD RD STE 300
BLUFFDALE UT
84065-5223
US

IV. Provider business mailing address

14241 S REDWOOD RD STE 300 BLDG A
BLUFFDALE UT
84065-5223
US

V. Phone/Fax

Practice location:
  • Phone: 385-342-2808
  • Fax:
Mailing address:
  • Phone: 385-342-2808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14309100-6009
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: