Healthcare Provider Details

I. General information

NPI: 1083100218
Provider Name (Legal Business Name): SABRENA NESS CMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2018
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5965 S 900 E STE 100
MURRAY UT
84121-1850
US

IV. Provider business mailing address

5965 S 900 E STE 100
MURRAY UT
84121-1850
US

V. Phone/Fax

Practice location:
  • Phone: 307-745-8915
  • Fax:
Mailing address:
  • Phone: 801-872-5516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number13549962-6004
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13549962-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: