Healthcare Provider Details

I. General information

NPI: 1588209399
Provider Name (Legal Business Name): TAYLER WILLIAM PACE LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2019
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 S MARKET ST STE 275
WEST VALLEY CITY UT
84119-3669
US

IV. Provider business mailing address

3535 S MARKET ST STE 275
WEST VALLEY CITY UT
84119-3669
US

V. Phone/Fax

Practice location:
  • Phone: 801-359-2256
  • Fax:
Mailing address:
  • Phone: 801-359-2256
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13418995-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: