Provider Demographics
NPI:1851743595
Name:VASGAR, ERICA (CSW)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:
Last Name:VASGAR
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:MS
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:LEIFUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW
Mailing Address - Street 1:88 W 50 S UNIT L5
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84014-2310
Mailing Address - Country:US
Mailing Address - Phone:510-501-9777
Mailing Address - Fax:
Practice Address - Street 1:857 E 200 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-2317
Practice Address - Country:US
Practice Address - Phone:801-487-3276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker