Healthcare Provider Details
I. General information
NPI: 1922551092
Provider Name (Legal Business Name): LEA FRANCES-POLL CMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/25/2016
Last Update Date: 05/24/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
ST GEORGE EXECUTIVE SUITES 169 WEST 2710 SOUTH CIRCLE, SUITE 203-A2
ST. GEORGE UT
84790-7206
US
IV. Provider business mailing address
ST. GEORGE EXECUTIVE SUITES 169 WEST 2710 SOUTH CIRCLE, SUITE 203-A2
SAINT GEORGE UT
84790-7206
US
V. Phone/Fax
- Phone: 435-288-1411
- Fax: 435-338-5378
- Phone: 435-288-1411
- Fax: 385-338-5378
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 134155-6004 |
| License Number State | UT |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: