Healthcare Provider Details

I. General information

NPI: 1649871211
Provider Name (Legal Business Name): LAURELIE DELLI GATTI MSW, CSWI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2020
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9561 S 700 E STE 101
SANDY UT
84070-3484
US

IV. Provider business mailing address

830 E ALTAMONT LAKE LN APT 1121
SANDY UT
84094-2805
US

V. Phone/Fax

Practice location:
  • Phone: 801-572-1696
  • Fax:
Mailing address:
  • Phone: 801-664-3001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6858753-3506
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number6858753-6006
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: