Healthcare Provider Details

I. General information

NPI: 1780507467
Provider Name (Legal Business Name): LEADERSHIP ACADEMY OF UTAH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1366 S LEGEND HILLS DR STE 190
CLEARFIELD UT
84015-2375
US

IV. Provider business mailing address

1366 S LEGEND HILLS DR STE 190
CLEARFIELD UT
84015-2375
US

V. Phone/Fax

Practice location:
  • Phone: 800-200-6869
  • Fax:
Mailing address:
  • Phone: 800-200-6869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: LUCIA STONE
Title or Position: MARRIAGE AND FAMILY THERAPIST
Credential: AMFT
Phone: 801-244-2341