Healthcare Provider Details

I. General information

NPI: 1235804535
Provider Name (Legal Business Name): RACHEL ANDREWS NELSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2021
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

276 E 950 S STE 200
OREM UT
84058-7054
US

IV. Provider business mailing address

276 E 950 S STE 200
OREM UT
84058-7054
US

V. Phone/Fax

Practice location:
  • Phone: 801-477-7732
  • Fax:
Mailing address:
  • Phone: 801-477-7732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12846295-3501
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: