Healthcare Provider Details

I. General information

NPI: 1083233506
Provider Name (Legal Business Name): STEPHANIE TAYLER LOBROT CMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2020
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4832 W CROSSWATER RD
SOUTH JORDAN UT
84009-6131
US

IV. Provider business mailing address

4832 W CROSSWATER RD
SOUTH JORDAN UT
84009-6131
US

V. Phone/Fax

Practice location:
  • Phone: 385-526-7973
  • Fax:
Mailing address:
  • Phone: 385-526-7973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number12201331-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: