Individual
SANDRA CHACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
628 N PUGSLEY ST, SALT LAKE CITY, UT 84103-1329
(385) 261-2171
(385) 261-2827
Mailing address
1595 N MANDALAY RD, SALT LAKE CITY, UT 84116-4130
(801) 991-0484
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
10366619-3501
UT
101YM0800X
Mental Health Counselor
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
876000308007
—
UT
Enumeration date
08/11/2015
Last updated
04/10/2026
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