MEDICARE: MR. SHANE MAYLIN PITCHER LCSW

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	7036797-3502	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7036797-3502	OTHER	UT	DOPL LISCENCE
2	7036797-3501	OTHER	UT	DOPL LISCENCE LCSW

General Provider Information

NPI Number	:	1487973863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SHANE MAYLIN PITCHER LCSW

Provider Business Mailing Address
First Line	:	5626 VISTA RIDGE WAY
Second Line	:
City	:	KEARNS
State	:	UT
Zip	:	84118-9354
Country	:	US
Telephone Number	:	801-894-8548
Fax Number	:

Provider Business Practice Location Address
First Line	:	645 S 1300 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-3206
Country	:	US
Telephone Number	:	385-227-8565
Fax Number	:

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

Provider Enumeration Date	:	05/24/2010
Last Update Date	:	12/18/2020

Similar Medicare Providers

1245230820 — RHA COMMUNITY SERVICES OF UTAH
Practice Location Address:

645 S 1300 E
SALT LAKE CITY, UT
84102-3206

Practice Phone: 801-582-1457
Practice Fax: 801-582-3901

1497472740 — WILLIAM HAGEE
Practice Location Address:

645 S 1300 E
SALT LAKE CITY, UT
84102-3206

Practice Phone: 385-500-2024
Practice Fax:

1699973461 — HIGHLAND COVE RETIREMENT COMMUNITY
Practice Location Address:

3750 HIGHLAND DR
SALT LAKE CITY, UT
84106-3206

Practice Phone: 801-272-8226
Practice Fax: 801-272-6811

1710624689 — NATASHA MEINE WORKMAN
Practice Location Address:

645 S 1300 E
SLC, UT
84102-3206

Practice Phone: 801-462-4582
Practice Fax:

1568432151 — DR. GERALD GOLD D.P.M.
Practice Location Address:

3206 ORCHARD LAKE RD
ORCHARD LAKE, MI
48324-1633

Practice Phone: 248-682-6662
Practice Fax: 248-682-2850

1649240375 — ORCHARD LAKE FOOTCARE SPECIALISTS, P.L.L.C.
Practice Location Address:

3206 ORCHARD LAKE RD
ORCHARD LAKE, MI
48324-1633

Practice Phone: 248-682-6662
Practice Fax: 248-682-2850

Directions to “ MR. SHANE MAYLIN PITCHER LCSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.