Provider Demographics
NPI:1912101932
Name:SCHELIN, C. HOLLIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:C.
Middle Name:HOLLIE
Last Name:SCHELIN
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:P O BOX 922
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84059
Mailing Address - Country:US
Mailing Address - Phone:801-809-3957
Mailing Address - Fax:801-224-1974
Practice Address - Street 1:276 E 950 S
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-7054
Practice Address - Country:US
Practice Address - Phone:801-809-3957
Practice Address - Fax:801-224-1974
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT32213235011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT101YM0800XMedicare ID - Type UnspecifiedCOUNSELOR MENTAL HEALTH