Provider Demographics
NPI:1730656679
Name:ALBUQUERQUE, MICHELLE CASSIA (LCSW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:CASSIA
Last Name:ALBUQUERQUE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:CASSIA
Other - Last Name:BEAMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:151 W SWAINSON AVE
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:UT
Mailing Address - Zip Code:84045-6461
Mailing Address - Country:US
Mailing Address - Phone:760-608-3818
Mailing Address - Fax:
Practice Address - Street 1:5373 S GREEN ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84123-4680
Practice Address - Country:US
Practice Address - Phone:801-442-2670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-29
Last Update Date:2025-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW1030411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical