Provider Demographics
NPI:1417537598
Name:FALK, LUCY ANN
Entity Type:Individual
Prefix:
First Name:LUCY
Middle Name:ANN
Last Name:FALK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LUCY
Other - Middle Name:ANN
Other - Last Name:GOCHNOUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:556 E 300 S STE 108
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-3844
Mailing Address - Country:US
Mailing Address - Phone:801-980-2566
Mailing Address - Fax:
Practice Address - Street 1:2046 E MURRAY HOLLADAY RD STE 101
Practice Address - Street 2:
Practice Address - City:HOLLADAY
Practice Address - State:UT
Practice Address - Zip Code:84117-5173
Practice Address - Country:US
Practice Address - Phone:801-980-2566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12267018-35021041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical