Healthcare Provider Details

I. General information

NPI: 1003752312
Provider Name (Legal Business Name): BURT ROWLEY LCSW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1791 N 280 W
OREM UT
84057-2133
US

IV. Provider business mailing address

29 W COTTAGE AVE
SANDY UT
84070-1474
US

V. Phone/Fax

Practice location:
  • Phone: 801-602-0231
  • Fax: 385-324-6610
Mailing address:
  • Phone: 801-518-2646
  • Fax: 385-324-6610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: BURT ROWLEY
Title or Position: OWNER
Credential: LCSW
Phone: 801-602-0231