Individual provider · Type 1 NPI

Stacy Noelani Pettersson, CHMC AND MHC

Mental Health Counselor · West Jordan, UT

NPI number 1104764935 Active

Practice location

3696 W Savannah Cir
West Jordan, UT 84084-1710

Call (801) 336-7624 Map

Mailing address

85 Delancey St
New York, NY 10002-3182

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800X929 (HI)
Mental Health Counselor Primary 101YM0800X13811151-6004 (UT)

Mental Health Counselor: Definition to come...

Other mental health counselor providers in West Jordan

See all in West Jordan →

About NPI 1104764935

Stacy Noelani Pettersson, CHMC AND MHC's National Provider Identifier is 1104764935, issued on Mar 23, 2026. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in West Jordan, UT. The record was last updated on Mar 23, 2026.