Healthcare Provider Details

I. General information

NPI: 1952219974
Provider Name (Legal Business Name): FELICIA HARRIS CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

266 S LEFT FORK HOBBLE CREEK CYN
SPRINGVILLE UT
84663-6165
US

IV. Provider business mailing address

266 S LEFT FORK HOBBLE CREEK CYN
SPRINGVILLE UT
84663-6165
US

V. Phone/Fax

Practice location:
  • Phone: 385-500-3529
  • Fax:
Mailing address:
  • Phone: 385-500-3529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14288863-3502
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: