Provider Demographics
NPI:1316154479
Name:SCOVILLE, DAVID PHILLIP (MS, LMFT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:PHILLIP
Last Name:SCOVILLE
Suffix:
Gender:M
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:PHIL
Other - Middle Name:
Other - Last Name:SCOVILLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LMFT
Mailing Address - Street 1:1426 E 820 N
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-5481
Mailing Address - Country:US
Mailing Address - Phone:801-709-1785
Mailing Address - Fax:
Practice Address - Street 1:1426 E 820 N
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-5481
Practice Address - Country:US
Practice Address - Phone:801-709-1785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6370628-3904106H00000X
CA49906106H00000X
UT6370628-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist