Healthcare Provider Details

I. General information

NPI: 1487558987
Provider Name (Legal Business Name): MOSAIC ASSESSMENT & PSYCHOTHERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 W BLUE GRASS BLVD STE 200
LEHI UT
84048-4190
US

IV. Provider business mailing address

7533 S CENTER VIEW CT # 5528
WEST JORDAN UT
84084-5526
US

V. Phone/Fax

Practice location:
  • Phone: 385-200-1566
  • Fax:
Mailing address:
  • Phone: 385-200-1566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: TAEKO MICHELLE COLBERT
Title or Position: MENTAL HEALTH COUNSELOR
Credential: LMCHC
Phone: 307-371-5429