Healthcare Provider Details

I. General information

NPI: 1275330995
Provider Name (Legal Business Name): TREVOR DANIELS LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2025
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4190 S HIGHLAND DR STE 107
MILLCREEK UT
84124-2600
US

IV. Provider business mailing address

4190 S HIGHLAND DR STE 107
MILLCREEK UT
84124-2600
US

V. Phone/Fax

Practice location:
  • Phone: 801-441-0032
  • Fax: 385-337-2094
Mailing address:
  • Phone: 801-441-0032
  • Fax: 385-337-2094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9398104-3502
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: