Healthcare Provider Details

I. General information

NPI: 1871458570
Provider Name (Legal Business Name): CONNOR JOHN HELLBERG LMHC INTERN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13552 S 110 W STE 204
DRAPER UT
84020-2403
US

IV. Provider business mailing address

10402 S WEEPING WILLOW DR
SANDY UT
84070-4244
US

V. Phone/Fax

Practice location:
  • Phone: 801-432-0883
  • Fax:
Mailing address:
  • Phone: 801-541-4906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: