Individual provider · Type 1 NPI
Shelly Rae Coburn, LCSW
Clinical Social Worker · Salt Lake City, UT
Practice location
1609 E Millcreek Way
Salt Lake City, UT 84106-3231
Mailing address
35 E 100 S Apt 1905
Salt Lake City, UT 84111-1989
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Social Worker Primary | 1041C0700X | 7970000-3501 (UT) |
Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…
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About NPI 1144867938
Shelly Rae Coburn, LCSW's National Provider Identifier is 1144867938, issued on Nov 29, 2019. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Salt Lake City, UT. The record was last updated on Jul 17, 2026.