MEDICARE: VALERIE LEAVITT 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	104100000X	Social Worker	5566912-3501	UT

General Provider Information

NPI Number	:	1730518747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE LEAVITT LCSW

Provider Business Mailing Address
First Line	:	669 E MILTON AVE
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84105-2112
Country	:	US
Telephone Number	:	801-556-1611
Fax Number	:	801-953-0982

Provider Business Practice Location Address
First Line	:	1399 S 700 E STE 12-E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84105-2149
Country	:	US
Telephone Number	:	891-556-1611
Fax Number	:	801-953-0982

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

Provider Enumeration Date	:	11/11/2013
Last Update Date	:	02/05/2026

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Directions to “ VALERIE LEAVITT LCSW” Practice Location

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