Individual provider · NPI-1
Peter Jay Elliott, LCSW
Social Worker, Clinical · Kaysville, UT
NPI number1245930528
StatusActive
Last updated in NPPESMar 6, 2023
Details
- NPI
- 1245930528
- Entity type
- Individual (NPI-1)
- Name
- Mr. Peter Jay Elliott
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 6, 2023
- Certification date
- Mar 6, 2023
- Last updated
- Mar 6, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 6217446-3501 | UT | Yes |
| 101YM0800X | Counselor, Mental Health | 6217446-3501 | UT | |
| 101YP2500X | Counselor, Professional | 6217446-3501 | UT |
Practice location
283 N 300 W Ste 501Kaysville, UT 84037-1881
Phone 801-759-7103
Mailing address
283 N 300 W Ste 501Kaysville, UT 84037-1881
Phone 801-759-7103
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