Provider Demographics
NPI:1992677306
Name:ACOSTA, ALEXIS (ACMHC)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:ACMHC
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ACMHC
Mailing Address - Street 1:1022 N 560 E
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-3349
Mailing Address - Country:US
Mailing Address - Phone:801-369-9674
Mailing Address - Fax:
Practice Address - Street 1:233 S PLEASANT GROVE BLVD STE 201
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062-2878
Practice Address - Country:US
Practice Address - Phone:801-410-0542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14222858-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health