Provider Demographics
NPI:1548076425
Name:MEYER, CHALESE (TRS, CTRS, CSW)
Entity type:Individual
Prefix:
First Name:CHALESE
Middle Name:
Last Name:MEYER
Suffix:
Gender:F
Credentials:TRS, CTRS, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 W 10460 S
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-8639
Mailing Address - Country:US
Mailing Address - Phone:435-237-7387
Mailing Address - Fax:
Practice Address - Street 1:2820 W 10460 S
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-8639
Practice Address - Country:US
Practice Address - Phone:435-237-7387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6963169-3502101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health