Provider Demographics
NPI:1871957795
Name:PUZEY, LILLIE MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:LILLIE
Middle Name:MARIE
Last Name:PUZEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LILLIE
Other - Middle Name:MARIE
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2952 S. 1375 W.
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:UT
Mailing Address - Zip Code:84075-9067
Mailing Address - Country:US
Mailing Address - Phone:801-674-9516
Mailing Address - Fax:
Practice Address - Street 1:610 N. KAYS DR.
Practice Address - Street 2:SUITE 101
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037
Practice Address - Country:US
Practice Address - Phone:801-923-8389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT345305-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical