MEDICARE: DR. KAREN CHECKETTS PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist	5080319-2501	UT
2	2084P0800X	Psychiatry Physician	5080319-2501	UT

General Provider Information

NPI Number	:	1114336617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN CHECKETTS PH.D.

Provider Business Mailing Address
First Line	:	PO BOX 27128
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84127-0128
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9035 S 1300 E
Second Line	:	B120
City	:	SANDY
State	:	UT
Zip	:	84094-3132
Country	:	US
Telephone Number	:	801-838-7606
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2014
Last Update Date	:	02/12/2026

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