Provider Demographics
NPI:1306710421
Name:DALLEY, ELIZABETH (ACMHC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:DALLEY
Suffix:
Gender:F
Credentials:ACMHC
Other - Prefix:
Other - First Name:BENNY
Other - Middle Name:
Other - Last Name:DALLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ACMHC
Mailing Address - Street 1:761 S 1000 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-3645
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:217 E SCENIC PEAK CV
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-9222
Practice Address - Country:US
Practice Address - Phone:801-282-6953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14223636-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health