Provider Demographics
NPI:1629005665
Name:BEYERS, PERRIANN PARKS (LCSW/MFT)
Entity Type:Individual
Prefix:MS
First Name:PERRIANN
Middle Name:PARKS
Last Name:BEYERS
Suffix:
Gender:F
Credentials:LCSW/MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:456 BREWSTER DR
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-5151
Mailing Address - Country:US
Mailing Address - Phone:801-558-7054
Mailing Address - Fax:801-523-8824
Practice Address - Street 1:9192 S0. 300 W.
Practice Address - Street 2:SUITE 19
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070
Practice Address - Country:US
Practice Address - Phone:801-558-7054
Practice Address - Fax:801-523-8824
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT136231-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical