MEDICARE: SYDNEY MALIA GURNEY CSW

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	1041C0700X	Clinical Social Worker	12145052-3502	UT

General Provider Information

NPI Number	:	1255202818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYDNEY MALIA GURNEY CSW

Provider Business Mailing Address
First Line	:	1350 E 8555 S
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84093-1342
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1350 E 8555 S
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84093-1342
Country	:	US
Telephone Number	:	801-761-4019
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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