Healthcare Provider Details

I. General information

NPI: 1497203665
Provider Name (Legal Business Name): PAIGE HUFF LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2016
Last Update Date: 09/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1724 S MAIN ST
SALT LAKE CTY UT
84115-1912
US

IV. Provider business mailing address

1724 S MAIN ST
SALT LAKE CTY UT
84115-1912
US

V. Phone/Fax

Practice location:
  • Phone: 801-486-5012
  • Fax:
Mailing address:
  • Phone: 801-486-5012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number8645736-3502
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8645736-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: