Individual
LILLIAM HENNINGSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 373-4760
(801) 373-0639
Mailing address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 373-4760
(801) 373-0639
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
4753056-3502
UT
1041C0700X
Clinical Social Worker
4753056-3502
UT
390200000X
Student in an Organized Health Care Education/Training Program
Primary
47530563102
UT
Other
Enumeration date
03/29/2007
Last updated
01/16/2025
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