Provider Demographics
NPI:1285672386
Name:DRAUGHAN, HEATHER LUND (LCSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:LUND
Last Name:DRAUGHAN
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 1:6890 S 2300 E STE 711610
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-6098
Mailing Address - Country:US
Mailing Address - Phone:801-317-1950
Mailing Address - Fax:801-317-1951
Practice Address - Street 1:4516 S 700 E STE 275
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-4192
Practice Address - Country:US
Practice Address - Phone:801-317-1950
Practice Address - Fax:801-317-1951
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4968-C1041C0700X
UT8463543-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100507624Medicaid