MEDICARE: VANESSA GUEVARA CMHC

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	13554745-6004	UT

General Provider Information

NPI Number	:	1184595845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA GUEVARA CMHC

Provider Business Mailing Address
First Line	:	2784 W SPARKFORD DR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84129-5110
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2784 W SPARKFORD DR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84129-5110
Country	:	US
Telephone Number	:	385-484-8377
Fax Number	:

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

Provider Enumeration Date	:	09/16/2025
Last Update Date	:	09/16/2025

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