# MARY BETH WHITTAKER LCSW

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538538525
- **Authorized official:** MARY BETH WHITTAKER LCSW (OWNER)
- **Authorized official phone:** (801) 272-3533

## Contact information

- **Practice address:** 2290 E 4500 S, SUITE 210, HOLLADAY, UT 84117-4492
- **Practice address phone:** (801) 272-3533
- **Practice address fax:** (801) 272-3636
- **Mailing address:** 2290 E 4500 S, SUITE 210, HOLLADAY, UT 84117-4492
- **Mailing address phone:** (801) 272-3533
- **Mailing address fax:** (801) 272-3636

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 130283-3501 | UT | Yes |

## Other

- **Enumeration date:** 09/19/2015
- **Last updated:** 09/19/2015