Provider Demographics
NPI:1285426510
Name:REIVES, ELIJAH EDWARD (MSW)
Entity type:Individual
Prefix:
First Name:ELIJAH
Middle Name:EDWARD
Last Name:REIVES
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3697 W CORDELLE CIR
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-1704
Mailing Address - Country:US
Mailing Address - Phone:385-237-9987
Mailing Address - Fax:
Practice Address - Street 1:6771 S 900 E
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-1436
Practice Address - Country:US
Practice Address - Phone:888-759-5846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)