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General NPI Number Information
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NPI Number | 1649933474
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Entity Type | Individual
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Provider Name | LORI STROUP CMHC
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Gender | Female
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Dates
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Enumeration Date | 10/19/2021
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 1111 E DRAPERPARKWAY SUITE #103
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City | DRAPER
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State | UT
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Zip | 84020
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Country | US
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Telephone | 385-842-1539
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Fax |
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Provider Business Mailing Address
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Address Line | 398 W CORNELL DR
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City | MIDVALE
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State | UT
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Zip | 84047
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Country | US
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Telephone | 385-842-1539
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 10562677-6004
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License Number State | UT
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