Provider Demographics
NPI:1649871211
Name:DELLI GATTI, LAURELIE (MSW, CSWI)
Entity type:Individual
Prefix:
First Name:LAURELIE
Middle Name:
Last Name:DELLI GATTI
Suffix:
Gender:F
Credentials:MSW, CSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2167 E EAGLE CHASE DR
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-5717
Mailing Address - Country:US
Mailing Address - Phone:801-850-7857
Mailing Address - Fax:
Practice Address - Street 1:5170 S HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:HOLLADAY
Practice Address - State:UT
Practice Address - Zip Code:84117-7048
Practice Address - Country:US
Practice Address - Phone:801-850-7857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6858753-6006101YA0400X
UT6858753-3506101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)