Healthcare Provider Details

I. General information

NPI: 1679284475
Provider Name (Legal Business Name): HEATHER MARIE STEVENSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2022
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 S 100 E STE 300
PAYSON UT
84651-2253
US

IV. Provider business mailing address

1182 E 300 S
SANTAQUIN UT
84655-5636
US

V. Phone/Fax

Practice location:
  • Phone: 801-382-9338
  • Fax:
Mailing address:
  • Phone: 801-270-5333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6298917-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: