MEDICARE: SARA ELLEN MATUSZAK

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

General Provider Information

NPI Number	:	1477392546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA ELLEN MATUSZAK

Provider Business Mailing Address
First Line	:	7533 S CENTER VIEW CT # 4543
Second Line	:
City	:	WEST JORDAN
State	:	UT
Zip	:	84084-5526
Country	:	US
Telephone Number	:	385-487-7160
Fax Number	:

Provider Business Practice Location Address
First Line	:	741 E BOGART LN
Second Line	:
City	:	MIDVALE
State	:	UT
Zip	:	84047-1774
Country	:	US
Telephone Number	:	385-487-7160
Fax Number	:

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

Provider Enumeration Date	:	05/20/2024
Last Update Date	:	12/11/2025

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Directions to “ SARA ELLEN MATUSZAK ” Practice Location

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