Provider Demographics
NPI:1548410970
Name:STRATTMAN, GENEVIEVE DIAN (LCSW)
Entity Type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:DIAN
Last Name:STRATTMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:GENEVIEVE
Other - Middle Name:DIAN
Other - Last Name:STRATTMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:8515 S BARNSTABLE DR
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84081-2904
Mailing Address - Country:US
Mailing Address - Phone:801-726-4657
Mailing Address - Fax:
Practice Address - Street 1:2500 S STATE ST
Practice Address - Street 2:
Practice Address - City:SOUTH SALT LAKE
Practice Address - State:UT
Practice Address - Zip Code:84115-3164
Practice Address - Country:US
Practice Address - Phone:385-646-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-23
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7130027-35021041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical