Provider Demographics
NPI:1902116254
Name:STONECLIFFE, MELINDA KAY (LCSW)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:KAY
Last Name:STONECLIFFE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3378 S 900 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84106-2070
Mailing Address - Country:US
Mailing Address - Phone:385-202-0071
Mailing Address - Fax:
Practice Address - Street 1:3378 S 900 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-2070
Practice Address - Country:US
Practice Address - Phone:385-202-0071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-19
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT707099735011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical