Provider Demographics
NPI:1891487435
Name:LYVER, EMILY ROSE (LCSW)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ROSE
Last Name:LYVER
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:EM
Other - Middle Name:
Other - Last Name:LYVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1399 S 700 E STE 1
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-2100
Mailing Address - Country:US
Mailing Address - Phone:360-213-9808
Mailing Address - Fax:
Practice Address - Street 1:1399 S 700 E STE 1
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105-2100
Practice Address - Country:US
Practice Address - Phone:360-213-9808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13425694-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical