Healthcare Provider Details

I. General information

NPI: 1851640684
Provider Name (Legal Business Name): TREVOR EARL CMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2012
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2975 W EXECUTIVE PKWY
LEHI UT
84048-9642
US

IV. Provider business mailing address

7847 N WINDHOVER RD
EAGLE MOUNTAIN UT
84005-4346
US

V. Phone/Fax

Practice location:
  • Phone: 801-369-5955
  • Fax:
Mailing address:
  • Phone: 801-369-5955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number9410722-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: