Provider Demographics
NPI:1063677342
Name:MCELREATH, AMBER LEE (CPCI)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LEE
Last Name:MCELREATH
Suffix:
Gender:F
Credentials:CPCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3657 W 12280 S
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84065-7603
Mailing Address - Country:US
Mailing Address - Phone:801-718-8895
Mailing Address - Fax:
Practice Address - Street 1:12427 S PASTURE RD STE 201
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84096-5608
Practice Address - Country:US
Practice Address - Phone:385-202-6113
Practice Address - Fax:382-271-0305
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-25
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7013166-6009101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional