Provider Demographics
NPI:1144535691
Name:NEMOVICHER, JOAN ALEXIS (LPC)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:ALEXIS
Last Name:NEMOVICHER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:
Other - Last Name:WORLOCK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:2440 E 900 S
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-1441
Mailing Address - Country:US
Mailing Address - Phone:801-582-9431
Mailing Address - Fax:
Practice Address - Street 1:2440 E 900 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108-1441
Practice Address - Country:US
Practice Address - Phone:801-582-9431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5012729-6004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional