Healthcare Provider Details

I. General information

NPI: 1447064852
Provider Name (Legal Business Name): START THERAPY SPECIALIZED TRAUMA AND RECOVERY TREATMENT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2025
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

471 HERITAGE PARK BLVD STE 4
LAYTON UT
84041-5655
US

IV. Provider business mailing address

1127 N 2825 W
LAYTON UT
84041-3400
US

V. Phone/Fax

Practice location:
  • Phone: 801-609-5515
  • Fax:
Mailing address:
  • Phone: 801-609-5515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: NICOLETTE KILLPACK
Title or Position: OWNER, PROVIDER
Credential: LCSW
Phone: 801-888-4657