Provider Demographics
NPI:1013994946
Name:NEUMAN, EVANGELINA ORTEGA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:EVANGELINA
Middle Name:ORTEGA
Last Name:NEUMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 S 1800 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-2937
Mailing Address - Country:US
Mailing Address - Phone:801-484-2274
Mailing Address - Fax:
Practice Address - Street 1:1753 SIDEWINDER DR
Practice Address - Street 2:SUITE S 200
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84060-7258
Practice Address - Country:US
Practice Address - Phone:435-649-9079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4891005-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTNPPOOOMedicare UPIN