Healthcare Provider Details

I. General information

NPI: 1639492036
Provider Name (Legal Business Name): MICHELLE MOYES LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2010
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

443 S 600 E
SALT LAKE CITY UT
84102-2708
US

IV. Provider business mailing address

3725 W 4100 S STE 201
WEST VALLEY CITY UT
84120-5427
US

V. Phone/Fax

Practice location:
  • Phone: 888-949-4864
  • Fax: 801-468-2006
Mailing address:
  • Phone: 888-949-4864
  • Fax: 801-468-2006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number347866-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: