Healthcare Provider Details

I. General information

NPI: 1366761934
Provider Name (Legal Business Name): CHERAL CHRISTIE CHIVERS CMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2010
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 W 400 S
SALT LAKE CITY UT
84101-1916
US

IV. Provider business mailing address

68 S 600 E
SALT LAKE CITY UT
84102-1007
US

V. Phone/Fax

Practice location:
  • Phone: 801-322-4257
  • Fax: 801-359-3864
Mailing address:
  • Phone: 801-428-3458
  • Fax: 801-359-3864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number7280587-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: