MEDICARE: ASHLEIGH CREPS 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	9811154-3501	UT

General Provider Information

NPI Number	:	1750767711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEIGH CREPS LCSW

Provider Business Mailing Address
First Line	:	2469 E FORT UNION BLVD STE 206
Second Line	:
City	:	COTTONWOOD HEIGHTS
State	:	UT
Zip	:	84121-3417
Country	:	US
Telephone Number	:	801-842-4161
Fax Number	:

Provider Business Practice Location Address
First Line	:	2469 E FORT UNION BLVD STE 206
Second Line	:
City	:	COTTONWOOD HEIGHTS
State	:	UT
Zip	:	84121-3417
Country	:	US
Telephone Number	:	801-842-4161
Fax Number	:

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

Provider Enumeration Date	:	07/31/2015
Last Update Date	:	04/04/2024

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