Healthcare Provider Details

I. General information

NPI: 1891430914
Provider Name (Legal Business Name): TRACY SWAPP LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TRACY WASHINGTON

II. Dates (important events)

Enumeration Date: 05/03/2022
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12226 S 1000 E STE 9
DRAPER UT
84020-3211
US

IV. Provider business mailing address

972 E DEER ARCH LN
DRAPER UT
84020-1369
US

V. Phone/Fax

Practice location:
  • Phone: 435-709-6771
  • Fax: 801-872-7695
Mailing address:
  • Phone: 801-842-1492
  • Fax: 801-872-7695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1891430914
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: