Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Stacy Noelani Pettersson, CHMCANDMHC

Individual provider Mental Health Counselor · NPI 1104764935

Stacy Noelani Pettersson, CHMCANDMHC is a Mental Health Counselor in West Jordan, Utah. Practices as a sole proprietor. Licensed in Hawaii and Utah.

Licensed in
HI, UT
In the registry since
2026
Specialties on file
2
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Practice location Address checks out

3696 W Savannah Cir
West Jordan, UT 84084-1710
Phone: (801) 336-7624
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 13811151-6004 (UT)
Mental Health Counselor Taxonomy 101YM0800X · Licence 929 (HI)

Record details

NPI number1104764935
Entity typeIndividual (Type 1)
GenderFemale
Credentials CHMCANDMHC
Sole proprietorYes
NPI enumeratedMarch 23, 2026
Last updated in NPPESMarch 23, 2026
Certification dateMarch 23, 2026

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