Provider Demographics
NPI:1891492823
Name:MAIO, EMILY E (LCSW)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:E
Last Name:MAIO
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11667 S EUREKA WAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-7916
Mailing Address - Country:US
Mailing Address - Phone:720-563-9299
Mailing Address - Fax:
Practice Address - Street 1:11075 S STATE ST STE 3
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-5165
Practice Address - Country:US
Practice Address - Phone:720-563-9299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-09
Last Update Date:2025-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12890348-3501101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health