Healthcare Provider Details

I. General information

NPI: 1821390790
Provider Name (Legal Business Name): FRANK DAVID ELDER LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2010
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 E 4800 S STE 220
MURRAY UT
84107-5533
US

IV. Provider business mailing address

1212 OAKRIDGE DR
CENTERVILLE UT
84014-1540
US

V. Phone/Fax

Practice location:
  • Phone: 385-368-8228
  • Fax:
Mailing address:
  • Phone: 385-368-8228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5153746-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: