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NPI Code Detail

MEDICARE: LANAE KIMBER CMHC

MEDICARE: LANAE KIMBER CMHC
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
1101YM0800XMental Health Counselor5819102-6004UT

General Provider Information

NPI Number : 1467878116
Entity Type Code : Individual
Provider Name (Legal Business Name) : LANAE KIMBER CMHC
Provider Business Mailing Address
First Line : 660 S 200 E STE 250
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84111-3846
Country : US
Telephone Number : 801-920-6770
Fax Number :
Provider Business Practice Location Address
First Line : 660 S 200 E STE 250
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84111-3846
Country : US
Telephone Number : 801-920-6770
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2014
Last Update Date : 06/09/2026

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Directions to “ LANAE KIMBER CMHC” Practice Location

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