NPI Code Details Logo

NPI 1639019037

NPI 1639019037 : LUCY IZARD COUNSELING PLLC : SALT LAKE CITY, UT

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1639019037
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    LUCY IZARD COUNSELING PLLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    03/30/2026
-----------------------------------------------------
    Last Update Date     |    03/30/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    150 S 600 E STE 4A 
-----------------------------------------------------
    City                 |    SALT LAKE CITY
-----------------------------------------------------
    State                |    UT
-----------------------------------------------------
    Zip                  |    84102-1961
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    470-725-9111
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    3801 S ASH CIR 
-----------------------------------------------------
    City                 |    SALT LAKE CITY
-----------------------------------------------------
    State                |    UT
-----------------------------------------------------
    Zip                  |    84109-3748
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    470-725-9111
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    THERAPIST/OWNER
-----------------------------------------------------
    Name                 |     LUCY H IZARD 
-----------------------------------------------------
    Credential           |    LCSW
-----------------------------------------------------
    Telephone            |    470-725-9111
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    261QM0801X
-----------------------------------------------------
    Taxonomy Name        |    Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.