Healthcare Provider Details

I. General information

NPI: 1861669285
Provider Name (Legal Business Name): NICHOLAS READ O'NEAL LCMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2008
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1188 W SPORTSPLEX DR STE 203
KAYSVILLE UT
84037-6817
US

IV. Provider business mailing address

1188 W SPORTSPLEX DR STE 203
KAYSVILLE UT
84037-6817
US

V. Phone/Fax

Practice location:
  • Phone: 801-529-0913
  • Fax: 801-779-7808
Mailing address:
  • Phone: 801-529-9013
  • Fax: 801-779-7808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13296176-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: