Healthcare Provider Details

I. General information

NPI: 1518692896
Provider Name (Legal Business Name): MICHELLE MACFARLANE LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2022
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 S INTERSTATE PLZ STE 100
LEHI UT
84043-8601
US

IV. Provider business mailing address

84 S 740 E
AMERICAN FORK UT
84003-2242
US

V. Phone/Fax

Practice location:
  • Phone: 385-236-4500
  • Fax:
Mailing address:
  • Phone: 801-300-7711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number13477891-3902
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: