Healthcare Provider Details

I. General information

NPI: 1144160953
Provider Name (Legal Business Name): Q PORSCHATIS LCSW, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 E 3900 S STE 101
HOLLADAY UT
84124-1781
US

IV. Provider business mailing address

2120 E 3900 S STE 101
HOLLADAY UT
84124-1781
US

V. Phone/Fax

Practice location:
  • Phone: 801-203-0329
  • Fax:
Mailing address:
  • Phone: 801-203-0329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: AMBER MARIE PORSCHATIS
Title or Position: OWNER
Credential: LCSW
Phone: 801-574-0181