Healthcare Provider Details

I. General information

NPI: 1689568362
Provider Name (Legal Business Name): REAL TALK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 02/28/2026
Certification Date: 02/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4055 S 700 E STE 204
SALT LAKE CITY UT
84107-2504
US

IV. Provider business mailing address

4055 S 700 E STE 204
SALT LAKE CITY UT
84107-2504
US

V. Phone/Fax

Practice location:
  • Phone: 801-382-9593
  • Fax:
Mailing address:
  • Phone: 801-382-9593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SASHA G FREED
Title or Position: OWNER
Credential: LCSW
Phone: 435-640-7516