Healthcare Provider Details

I. General information

NPI: 1881519106
Provider Name (Legal Business Name): HOLLY LEWIS CLAWSON CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HOLLY LEWIS CSW

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5411 S VINE ST UNIT 1B
MURRAY UT
84107-7769
US

IV. Provider business mailing address

5411 S VINE ST UNIT 1B
MURRAY UT
84107-7769
US

V. Phone/Fax

Practice location:
  • Phone: 801-822-2912
  • Fax:
Mailing address:
  • Phone: 801-822-2912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14222989-3502
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: