Provider Demographics
NPI:1285119933
Name:WEBSTER, PEGGY (CMHC)
Entity type:Individual
Prefix:
First Name:PEGGY
Middle Name:
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 S OREM BLVD
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-5011
Mailing Address - Country:US
Mailing Address - Phone:801-465-5111
Mailing Address - Fax:
Practice Address - Street 1:901 S OREM BLVD
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-5011
Practice Address - Country:US
Practice Address - Phone:801-465-5111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-28
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT369760-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health