Healthcare Provider Details

I. General information

NPI: 1124932421
Provider Name (Legal Business Name): PHIL SCOVILLE LMFT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1426 E 820 N
OREM UT
84097-5481
US

IV. Provider business mailing address

1426 E 820 N
OREM UT
84097-5481
US

V. Phone/Fax

Practice location:
  • Phone: 801-709-1785
  • Fax:
Mailing address:
  • Phone: 801-709-1785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. DAVID PHILLIP SCOVILLE
Title or Position: OWNER
Credential: MS
Phone: 801-709-1785