Healthcare Provider Details

I. General information

NPI: 1184569683
Provider Name (Legal Business Name): CASSIDY L NORDHOFF CMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5627 W 13100 S STE B
HERRIMAN UT
84096-7013
US

IV. Provider business mailing address

5627 W 13100 S STE B
HERRIMAN UT
84096-7013
US

V. Phone/Fax

Practice location:
  • Phone: 801-893-2383
  • Fax:
Mailing address:
  • Phone: 801-217-9600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13696453-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: