MEDICARE: ANNA O'HEARON LCMHC

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
1	101YM0800X	Mental Health Counselor	LH61650025	WA
2	101YM0800X	Mental Health Counselor	10244584-6009	UT

General Provider Information

NPI Number	:	1093273708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA O'HEARON LCMHC

Provider Business Mailing Address
First Line	:	6975 S UNION PARK CTR STE 600
Second Line	:
City	:	COTTONWOOD HEIGHTS
State	:	UT
Zip	:	84047-4187
Country	:	US
Telephone Number	:	801-915-7518
Fax Number	:

Provider Business Practice Location Address
First Line	:	6975 S UNION PARK CTR STE 600
Second Line	:
City	:	COTTONWOOD HEIGHTS
State	:	UT
Zip	:	84047-4187
Country	:	US
Telephone Number	:	801-915-7518
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2019
Last Update Date	:	06/29/2025

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