Provider Demographics
NPI:1538716089
Name:LITCHFIELD, ANJANETTE (CSW)
Entity type:Individual
Prefix:
First Name:ANJANETTE
Middle Name:
Last Name:LITCHFIELD
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:ANJI
Other - Middle Name:
Other - Last Name:LITCHFIELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CSW
Mailing Address - Street 1:5882 S 1100 E
Mailing Address - Street 2:
Mailing Address - City:SOUTH OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84405-4886
Mailing Address - Country:US
Mailing Address - Phone:801-882-3178
Mailing Address - Fax:
Practice Address - Street 1:2661 WASHINGTON BLVD STE 102
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-3606
Practice Address - Country:US
Practice Address - Phone:801-621-8670
Practice Address - Fax:801-621-4512
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11305662-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical