Provider Demographics
NPI:1235694589
Name:SCHMELZER, ALINA OLSEN (LCSW)
Entity Type:Individual
Prefix:
First Name:ALINA
Middle Name:OLSEN
Last Name:SCHMELZER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 E PHEASANT WAY
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-1313
Mailing Address - Country:US
Mailing Address - Phone:513-519-0978
Mailing Address - Fax:
Practice Address - Street 1:4527 S 2300 E STE 206
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117-4446
Practice Address - Country:US
Practice Address - Phone:801-609-8351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6192427-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty