Healthcare Provider Details

I. General information

NPI: 1700734324
Provider Name (Legal Business Name): VANESSA LEIGH HANSEN ACMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VANESSA LEIGH CASEBOLT ACMHC

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 03/19/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1426 EAST 800 NORTH
OREM UT
84651-3441
US

IV. Provider business mailing address

1426 EAST 800 NORTH
OREM UT
84651-3441
US

V. Phone/Fax

Practice location:
  • Phone: 801-477-0041
  • Fax:
Mailing address:
  • Phone: 801-477-0041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14244890-6009
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: