Provider Demographics
NPI:1285227256
Name:LACHMAR, ELLEN M (LMFT, PHD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:M
Last Name:LACHMAR
Suffix:
Gender:F
Credentials:LMFT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 W SAN RAFAEL CT
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-9508
Mailing Address - Country:US
Mailing Address - Phone:435-512-9000
Mailing Address - Fax:
Practice Address - Street 1:54 W SAN RAFAEL CT
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-9508
Practice Address - Country:US
Practice Address - Phone:435-512-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-19
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11324965-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist