Healthcare Provider Details

I. General information

NPI: 1881524437
Provider Name (Legal Business Name): REBEKAH LEIGH ROBERTS ACMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 S 600 E
SALT LAKE CITY UT
84102-4013
US

IV. Provider business mailing address

1760 E DOWNINGTON AVE
SALT LAKE CITY UT
84108-2910
US

V. Phone/Fax

Practice location:
  • Phone: 801-613-7198
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14289583-6009
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: