Healthcare Provider Details

I. General information

NPI: 1659092351
Provider Name (Legal Business Name): AMBER MARIE RANGEL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMBER CHECKETTS

II. Dates (important events)

Enumeration Date: 09/09/2022
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10408 S 1055 W STE 101
SOUTH JORDAN UT
84095-1511
US

IV. Provider business mailing address

1433 N 1200 W
OREM UT
84057-2449
US

V. Phone/Fax

Practice location:
  • Phone: 801-655-5450
  • Fax: 385-225-9327
Mailing address:
  • Phone: 801-655-5450
  • Fax: 385-225-9327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13993568-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: