Provider Demographics
NPI:1598266553
Name:ORTEGA, ERICKA BRONTE (CMHC)
Entity Type:Individual
Prefix:
First Name:ERICKA
Middle Name:BRONTE
Last Name:ORTEGA
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 E 3100 N STE 2
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84040-2408
Mailing Address - Country:US
Mailing Address - Phone:307-399-2896
Mailing Address - Fax:
Practice Address - Street 1:1730 E 3100 N STE 2
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84040-2408
Practice Address - Country:US
Practice Address - Phone:307-399-2896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-26
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
UT12317217-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator