Healthcare Provider Details

I. General information

NPI: 1003354119
Provider Name (Legal Business Name): ALISHA DELACRUZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2017
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 S PLEASANT GROVE BLVD
PLEASANT GROVE UT
84062-2877
US

IV. Provider business mailing address

233 S PLEASANT GROVE BLVD
PLEASANT GROVE UT
84062-2877
US

V. Phone/Fax

Practice location:
  • Phone: 801-410-0542
  • Fax:
Mailing address:
  • Phone: 801-410-0542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10882419-3501
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberMSW007607
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: