Healthcare Provider Details

I. General information

NPI: 1134051766
Provider Name (Legal Business Name): GAYLE O'SCANLON MSW, CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3674 W SOUTH JORDAN PKWY STE 101
SOUTH JORDAN UT
84009-7160
US

IV. Provider business mailing address

3674 W SOUTH JORDAN PKWY STE 101
SOUTH JORDAN UT
84009-7160
US

V. Phone/Fax

Practice location:
  • Phone: 801-349-9606
  • Fax:
Mailing address:
  • Phone: 801-349-9606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14074785-3502
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: