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General NPI Number Information
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NPI Number | 1548983547
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Entity Type | Organization
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Legal Business Name | COREWORK, LLC
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Dates
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Enumeration Date | 09/23/2022
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Last Update Date | 09/23/2022
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Provider Practice Location Address
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Address Line | 2732 W LIZZI CV
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-7961
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Country | US
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Telephone | 760-769-6637
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Fax |
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Provider Business Mailing Address
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Address Line | 1878 W 12600 S # 337
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City | RIVERTON
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State | UT
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Zip | 84065-7026
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Country | US
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Telephone | 801-769-6637
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Fax |
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Authorized Official
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Title or Position | OWNER, DIRECTOR, THERAPIST
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Name | APRIL LYNNE' BENNETT
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Credential | LMFT
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Telephone | 801-769-6637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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