Healthcare Provider Details

I. General information

NPI: 1225875586
Provider Name (Legal Business Name): MIKAYLEE FORREST LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MIKAYLEE MOHR

II. Dates (important events)

Enumeration Date: 07/12/2024
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1173 S 250 W STE 501
ST GEORGE UT
84770-7308
US

IV. Provider business mailing address

498 N KAYS DR STE 210
KAYSVILLE UT
84037-4153
US

V. Phone/Fax

Practice location:
  • Phone: 801-738-4653
  • Fax: 435-703-6499
Mailing address:
  • Phone: 801-738-4653
  • Fax: 435-703-6499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13342672
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: