Healthcare Provider Details

I. General information

NPI: 1912516147
Provider Name (Legal Business Name): LEXIE HASLEM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2020
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

388 W CENTER ST
OREM UT
84057-4659
US

IV. Provider business mailing address

1398 W BEACON HILL CIR
TAYLORSVILLE UT
84123-4803
US

V. Phone/Fax

Practice location:
  • Phone: 801-960-3131
  • Fax: 800-785-2607
Mailing address:
  • Phone: 628-222-9621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberBBH-LCPC-LIC-84289
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: