Healthcare Provider Details

I. General information

NPI: 1235669524
Provider Name (Legal Business Name): HILARY BLACK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2017
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2797 N HIGHWAY 89 STE 301
PLEASANT VIEW UT
84404-1247
US

IV. Provider business mailing address

5742 ADAMS AVE PKWY STE C
WASHINGTON TERRACE UT
84405-7158
US

V. Phone/Fax

Practice location:
  • Phone: 385-250-3314
  • Fax:
Mailing address:
  • Phone: 385-250-3314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10358501-3506
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: