Healthcare Provider Details

I. General information

NPI: 1558939140
Provider Name (Legal Business Name): AMANDA DOWNS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2021
Last Update Date: 06/11/2021
Certification Date: 05/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3298 S BOOTS WAY
SYRACUSE UT
84075-1109
US

IV. Provider business mailing address

10605 S 1055 W
SOUTH JORDAN UT
84095-8519
US

V. Phone/Fax

Practice location:
  • Phone: 801-712-3428
  • Fax:
Mailing address:
  • Phone: 801-712-3428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

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: