Healthcare Provider Details

I. General information

NPI: 1750228938
Provider Name (Legal Business Name): STEPHANIE SANTANA GALVAN CMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 E 400 S
BOUNTIFUL UT
84010-4919
US

IV. Provider business mailing address

235 W 650 N
HEBER CITY UT
84032-1449
US

V. Phone/Fax

Practice location:
  • Phone: 801-214-1283
  • Fax:
Mailing address:
  • Phone: 435-503-5743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14245200-6009
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: