Healthcare Provider Details

I. General information

NPI: 1114880739
Provider Name (Legal Business Name): CHERYL MONTERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12523 S PASTURE RD STE 250
RIVERTON UT
84096-4842
US

IV. Provider business mailing address

4576 W BIRKDALE DR
HERRIMAN UT
84096-1998
US

V. Phone/Fax

Practice location:
  • Phone: 801-796-2039
  • Fax:
Mailing address:
  • Phone: 801-867-1473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: