Healthcare Provider Details

I. General information

NPI: 1467700492
Provider Name (Legal Business Name): CANDICE PRESCOTT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2012
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 N 700 E
MORGAN UT
84050-9714
US

IV. Provider business mailing address

921 N 700 E
MORGAN UT
84050-9714
US

V. Phone/Fax

Practice location:
  • Phone: 801-380-0248
  • Fax:
Mailing address:
  • Phone: 801-380-0248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-5051
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: