Provider Demographics
NPI:1437506128
Name:SMITH, TANYA BEESLEY (LCMHC, ASUDC)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:BEESLEY
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCMHC, ASUDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 E 100 N
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-1931
Mailing Address - Country:US
Mailing Address - Phone:858-750-0542
Mailing Address - Fax:
Practice Address - Street 1:383 N STATE ST STE 201
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-4781
Practice Address - Country:US
Practice Address - Phone:385-312-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-23
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health