Healthcare Provider Details

I. General information

NPI: 1336629930
Provider Name (Legal Business Name): ROXANNE SETTAREH RAHIMI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SETTA RAHIMI

II. Dates (important events)

Enumeration Date: 08/14/2018
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6211 S HIGHLAND DR # 4122
HOLLADAY UT
84121-2125
US

IV. Provider business mailing address

6211 S HIGHLAND DR # 4122
HOLLADAY UT
84121-2125
US

V. Phone/Fax

Practice location:
  • Phone: 435-233-7726
  • Fax:
Mailing address:
  • Phone: 435-233-7726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11273-M
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14184588-3501
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberIC-2377
License Number StateNV

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: