Healthcare Provider Details

I. General information

NPI: 1982900528
Provider Name (Legal Business Name): MICHAEL ADAM ASHCROFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2011
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1504 CHAPEL ST
SANTA CLARA UT
84765-5326
US

IV. Provider business mailing address

1504 CHAPEL ST
SANTA CLARA UT
84765-5326
US

V. Phone/Fax

Practice location:
  • Phone: 702-750-8020
  • Fax:
Mailing address:
  • Phone: 702-750-8020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number142346623501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: