Healthcare Provider Details

I. General information

NPI: 1649653411
Provider Name (Legal Business Name): EVA LENORE ALBERT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2015
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 W 400 S
MT. PLEASANT UT
84647
US

IV. Provider business mailing address

PO BOX 487
EPHRAIM UT
84627-0487
US

V. Phone/Fax

Practice location:
  • Phone: 541-778-2341
  • Fax: 541-702-0002
Mailing address:
  • Phone: 541-778-2341
  • Fax: 541-702-0002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13642170-3501
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL10960
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: