Provider Demographics
NPI:1912108515
Name:GARCIA-LEAVITT, ELIZABETH R (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:R
Last Name:GARCIA-LEAVITT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:R
Other - Last Name:LEAVITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1331 E LUCK SPRING DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84106-2947
Mailing Address - Country:US
Mailing Address - Phone:801-755-4574
Mailing Address - Fax:
Practice Address - Street 1:729 S ARAPEEN DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108-1218
Practice Address - Country:US
Practice Address - Phone:801-581-4771
Practice Address - Fax:801-581-2483
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5696385-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical