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General NPI Number Information
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NPI Number | 1992677306
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Entity Type | Individual
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Provider Name | ALEXIS ACOSTA ACMHC
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Gender | Female
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 233 S PLEASANT GROVE BLVD STE 201
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-2878
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Country | US
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Telephone | 801-410-0542
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Fax |
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Provider Business Mailing Address
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Address Line | 1022 N 560 E
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City | OREM
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State | UT
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Zip | 84097-3349
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Country | US
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Telephone | 801-369-9674
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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 | 14222858-6009
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License Number State | UT
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