Healthcare Provider Details
I. General information
NPI: 1639019037
Provider Name (Legal Business Name): LUCY IZARD COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
150 S 600 E STE 4A
SALT LAKE CITY UT
84102-1961
US
IV. Provider business mailing address
3801 S ASH CIR
SALT LAKE CITY UT
84109-3748
US
V. Phone/Fax
- Phone: 470-725-9111
- Fax:
- Phone: 470-725-9111
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LUCY
H
IZARD
Title or Position: THERAPIST/OWNER
Credential: LCSW
Phone: 470-725-9111