Healthcare Provider Details

I. General information

NPI: 1902789829
Provider Name (Legal Business Name): BECOME YOU THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2721 N 400 E
NORTH OGDEN UT
84414-2393
US

IV. Provider business mailing address

2721 N 400 E
NORTH OGDEN UT
84414-2393
US

V. Phone/Fax

Practice location:
  • Phone: 801-332-9586
  • Fax:
Mailing address:
  • Phone: 801-332-9586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHELNECHA LOWRY
Title or Position: CO-OWNER
Credential: LCSW
Phone: 801-654-4986