Healthcare Provider Details

I. General information

NPI: 1891492823
Provider Name (Legal Business Name): EMILY E MAIO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2023
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11075 S STATE ST STE 3
SANDY UT
84070-5165
US

IV. Provider business mailing address

11667 S EUREKA WAY
SOUTH JORDAN UT
84095-7916
US

V. Phone/Fax

Practice location:
  • Phone: 720-563-9299
  • Fax:
Mailing address:
  • Phone: 720-563-9299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12890348-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: