Provider Demographics
NPI:1790131795
Name:SMITH, ANNE FELT (CMHC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:FELT
Last Name:SMITH
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 1:1924 E SIGGARD DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84106-3838
Mailing Address - Country:US
Mailing Address - Phone:801-244-2087
Mailing Address - Fax:
Practice Address - Street 1:6770 S 900 E STE 105
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-1710
Practice Address - Country:US
Practice Address - Phone:801-305-3171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-09
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10378587-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health