Provider Demographics
NPI:1174923510
Name:PINEGAR, SUSAN HAIGHT (LCSW)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:HAIGHT
Last Name:PINEGAR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 S REDWOOD ROAD
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84104
Mailing Address - Country:US
Mailing Address - Phone:801-355-2846
Mailing Address - Fax:801-875-4515
Practice Address - Street 1:1875 S REDWOOD ROAD
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84104
Practice Address - Country:US
Practice Address - Phone:801-355-2846
Practice Address - Fax:801-875-4515
Is Sole Proprietor?:No
Enumeration Date:2014-09-03
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
UT9443076-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT3004332Medicaid