Healthcare Provider Details

I. General information

NPI: 1073485702
Provider Name (Legal Business Name): ALLYSON MARY EGGLETON CSW, LCSW, LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2025
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5677 S REDWOOD RD UNIT 18
TAYLORSVILLE UT
84123-5454
US

IV. Provider business mailing address

5677 S REDWOOD RD UNIT 18
TAYLORSVILLE UT
84123-5454
US

V. Phone/Fax

Practice location:
  • Phone: 385-526-5996
  • Fax:
Mailing address:
  • Phone: 385-526-5996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLCSW2141230
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number11111
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number14236261-3502
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: