Healthcare Provider Details

I. General information

NPI: 1356299986
Provider Name (Legal Business Name): NICOLE THORPE CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

520 E 770 N
OREM UT
84097-4101
US

IV. Provider business mailing address

90 S 200 E
SPRINGVILLE UT
84663-1412
US

V. Phone/Fax

Practice location:
  • Phone: 801-695-4451
  • Fax:
Mailing address:
  • Phone: 801-390-0724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number14276015-3502
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: