Healthcare Provider Details

I. General information

NPI: 1780442236
Provider Name (Legal Business Name): KILEE LUTHI CMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5796 S 900 E
MURRAY UT
84121-1036
US

IV. Provider business mailing address

6571 S NOD HILL RD APT 22
COTTONWOOD HEIGHTS UT
84121-2680
US

V. Phone/Fax

Practice location:
  • Phone: 385-436-2075
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13760593-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: