Healthcare Provider Details

I. General information

NPI: 1134051873
Provider Name (Legal Business Name): CODY STEN SWENSON LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1431 S 550 E
OREM UT
84097-7710
US

IV. Provider business mailing address

269 W 1700 S
OREM UT
84058-7453
US

V. Phone/Fax

Practice location:
  • Phone: 801-515-2282
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number13768073-3902
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: