MEDICARE: DEPTH OF HEART LLC

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

General Provider Information

NPI Number	:	1982550455
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEPTH OF HEART LLC

Provider Business Mailing Address
First Line	:	9119 MONROE ST
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84070-2682
Country	:	US
Telephone Number	:	385-481-8811
Fax Number	:

Provider Business Practice Location Address
First Line	:	9119 MONROE ST
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84070-2682
Country	:	US
Telephone Number	:	385-481-8811
Fax Number	:

Authorized Official
Title or Position	:	LCSW
Name	:	JAMES ANTHON BEECH
Credential	:
Telephone Number	:	385-481-8811

Provider Enumeration Date	:	03/07/2026
Last Update Date	:	03/07/2026

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Directions to “DEPTH OF HEART LLC ” Practice Location

Language	Start Address	Practice Location

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