Healthcare Provider Details

I. General information

NPI: 1285923102
Provider Name (Legal Business Name): SIOSIFA TAFISI LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: SIFA TAFISI LCSW

II. Dates (important events)

Enumeration Date: 03/31/2011
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5965 S 900 E
SALT LAKE CITY UT
84121-1720
US

IV. Provider business mailing address

1050 E 3300 S
MILLCREEK UT
84106-2184
US

V. Phone/Fax

Practice location:
  • Phone: 801-263-7100
  • Fax:
Mailing address:
  • Phone: 385-313-7149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8431802-3501
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: