Healthcare Provider Details

I. General information

NPI: 1427702125
Provider Name (Legal Business Name): NATASCHA PATRICIA CARLUCCI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2022
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 N TRIUMPH BLVD STE 100
LEHI UT
84043-5046
US

IV. Provider business mailing address

1557 W 200 S APT E201
SALT LAKE CITY UT
84104-7004
US

V. Phone/Fax

Practice location:
  • Phone: 385-595-5761
  • Fax:
Mailing address:
  • Phone: 757-771-7842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12732735-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: