Provider Demographics
NPI:1679812812
Name:TAGGART, CHRISTOPHER STEVEN (LCSW)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:STEVEN
Last Name:TAGGART
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 W 160 N
Mailing Address - Street 2:
Mailing Address - City:LA VERKIN
Mailing Address - State:UT
Mailing Address - Zip Code:84745-5238
Mailing Address - Country:US
Mailing Address - Phone:435-590-2370
Mailing Address - Fax:
Practice Address - Street 1:325 W 600 N
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:UT
Practice Address - Zip Code:84737-1682
Practice Address - Country:US
Practice Address - Phone:435-590-2370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-07
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8965132-3501101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health