Individual
NICOLE VAN LEEUWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
780 S GUARDSMAN WAY, SALT LAKE CITY, UT 84108-1374
(888) 949-4864
Mailing address
3725 W 4100 S STE 201, SALT LAKE CITY, UT 84120-6490
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
14218600-6009
UT
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
05/26/2020
Last updated
09/02/2025
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