Healthcare Provider Details

I. General information

NPI: 1659960151
Provider Name (Legal Business Name): LEXIE IVERSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LEXIE MURDOCK

II. Dates (important events)

Enumeration Date: 01/11/2021
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 W 800 S
ROOSEVELT UT
84066
US

IV. Provider business mailing address

1140 W 500 S STE 9
VERNAL UT
84078-2912
US

V. Phone/Fax

Practice location:
  • Phone: 435-725-6300
  • Fax: 435-725-6325
Mailing address:
  • Phone: 435-725-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: