# BLUE CLOVER THERAPY

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

## Provider details

- **NPI number:** 1700249844
- **Authorized official:** JESSIE SHEPHERD LCMHC (OWNER THERAPIST)
- **Authorized official phone:** (801) 206-4321

## Contact information

- **Practice address:** 2825 E COTTONWOOD PKWY, SUITE 500, SALT LAKE CITY, UT 84121-7055
- **Practice address phone:** (801) 206-4321
- **Mailing address:** 2825 E COTTONWOOD PKWY, SUITE 500, SALT LAKE CITY, UT 84121-7055
- **Mailing address phone:** (801) 206-4321

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 9706026-0160 | UT | Yes |

## Other

- **Enumeration date:** 04/05/2016
- **Last updated:** 04/05/2016