Healthcare Provider Details

I. General information

NPI: 1366264798
Provider Name (Legal Business Name): MARGARITA JACKIE ARTEAGA ALCANTARA CMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4465 S 900 E STE 150
MILLCREEK UT
84124-3944
US

IV. Provider business mailing address

4465 S 900 E STE 150
MILLCREEK UT
84124-3944
US

V. Phone/Fax

Practice location:
  • Phone: 435-248-2089
  • Fax: 801-207-5104
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: