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NPI Code Detail

MEDICARE: LISSET DELGADO CSW

MEDICARE: LISSET DELGADO 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
11041C0700XClinical Social Worker14289486-3502UT

General Provider Information

NPI Number : 1700702529
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISSET DELGADO CSW
Provider Business Mailing Address
First Line : 117 W 400 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84101-1916
Country : US
Telephone Number : 385-200-0110
Fax Number :
Provider Business Practice Location Address
First Line : 117 W 400 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84101-1916
Country : US
Telephone Number : 385-200-0110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2026
Last Update Date : 06/25/2026

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Directions to “ LISSET DELGADO CSW” Practice Location

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