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NPI Code Detail

MEDICARE: MERRITT GRACE LEBRECHT ACMHC, TRS, CTRS

MEDICARE:   MERRITT GRACE LEBRECHT  ACMHC, TRS, CTRS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225800000XRecreation Therapist12103709-4002UT
2101YM0800XMental Health Counselor12103709-6009UT

General Provider Information

NPI Number : 1033849633
Entity Type Code : Individual
Provider Name (Legal Business Name) : MERRITT GRACE LEBRECHT ACMHC, TRS, CTRS
Provider Business Mailing Address
First Line : 13417 S AINTREE AVE
Second Line :
City : DRAPER
State : UT
Zip : 84020-8887
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 18406 W WHITE QUEST DR
Second Line :
City : EAGLE MOUNTAIN
State : UT
Zip : 84013-9701
Country : US
Telephone Number : 801-335-4699
Fax Number : 801-335-7031
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2022
Last Update Date : 11/13/2023

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Directions to “ MERRITT GRACE LEBRECHT ACMHC, TRS, CTRS” Practice Location

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