Provider Demographics
NPI:1922069244
Name:SANDERS, ASHLEY ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ANN
Last Name:SANDERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:RENCHER
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:838 S 550 E
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-7132
Mailing Address - Country:US
Mailing Address - Phone:801-661-6547
Mailing Address - Fax:
Practice Address - Street 1:205 E 400 S
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-6311
Practice Address - Country:US
Practice Address - Phone:801-426-6624
Practice Address - Fax:801-426-6645
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
UT5674524-35011041C0700X
UT5674524-3502104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker