Healthcare Provider Details

I. General information

NPI: 1639919301
Provider Name (Legal Business Name): ROSEMARY ALICE MCVEA CSW, SUDC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2024
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 57092
MURRAY UT
84157-0092
US

IV. Provider business mailing address

440 S 500 E
SALT LAKE CITY UT
84102-2705
US

V. Phone/Fax

Practice location:
  • Phone: 801-382-7848
  • Fax:
Mailing address:
  • Phone: 801-359-8862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13926441-3502
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number13926441-6005
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: