Healthcare Provider Details

I. General information

NPI: 1285330746
Provider Name (Legal Business Name): MEGAN COLLEEN SANDERS CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 E 3300 S
SALT LAKE CITY UT
84106-2184
US

IV. Provider business mailing address

10675 S 700 E APT 5
SANDY UT
84070-4915
US

V. Phone/Fax

Practice location:
  • Phone: 801-645-5455
  • Fax:
Mailing address:
  • Phone: 435-559-9035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11663737-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: