Provider Demographics
NPI:1841740800
Name:BILLS, SHAWN (LMFT)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:BILLS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9263 S REDWOOD RD BLDG 8
Mailing Address - Street 2:STE B
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-6571
Mailing Address - Country:US
Mailing Address - Phone:801-566-0749
Mailing Address - Fax:801-566-7108
Practice Address - Street 1:9263 S REDWOOD RD BLDG 8
Practice Address - Street 2:STE B
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-6571
Practice Address - Country:US
Practice Address - Phone:801-566-0749
Practice Address - Fax:801-566-7108
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9867547-3904106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist