Healthcare Provider Details

I. General information

NPI: 1962845271
Provider Name (Legal Business Name): SCOTT DAVID HILL LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2013
Last Update Date: 12/14/2021
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5965 S 900 E
MURRAY UT
84121-1720
US

IV. Provider business mailing address

341 E GARFIELD AVE
SALT LAKE CITY UT
84115-2211
US

V. Phone/Fax

Practice location:
  • Phone: 801-386-0352
  • Fax:
Mailing address:
  • Phone: 801-386-0352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5746106-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: