Lisa Rae Chatelain, LSAC
Individual provider Active NPI Clinical Social Worker · Holladay, UT
NPI 1629375787 · NPPES record last updated Sep 18, 2025
Key facts
- NPI
- 1629375787
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Practice address
- 4326 S Holladay Blvd
Holladay, UT 84124-2702 - Phone
- (801) 541-5512
- NPI assigned
- Feb 24, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7491770-6006 | UT | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 7491770-6006 | UT | |
| Clinical Social Worker | 1041C0700X | Yes |
Addresses
Primary practice location
4326 S Holladay Blvd
Holladay, UT 84124-2702
Mailing address
4326 S Holladay Blvd
Holladay, UT 84124-2702
Phone (801) 541-5512
Other providers in Holladay, UT
- Matthew Carmody
- Andrea Kristina Carrizo
- Autum Cates
- Center for Counseling Excellence
- Albert Chandler
- Matthew Chaus
- Karl Chen
- David L Christensen
- Katie Lynn Christensen
- Judy Huynh Chung
All providers in Holladay, UT · Clinical Social Worker in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.