Healthcare Provider Details

I. General information

NPI: 1760261069
Provider Name (Legal Business Name): MAKENNA ALEECE MORGAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2023
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5119 W DAYBREAK PKWY
SOUTH JORDAN UT
84009-4858
US

IV. Provider business mailing address

3861 S APEX MINE DR
MAGNA UT
84044-2882
US

V. Phone/Fax

Practice location:
  • Phone: 801-417-5734
  • Fax:
Mailing address:
  • Phone: 385-285-2594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13602545-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: