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NPI Code Detail

MEDICARE: SARAH HOPKINS SAMORE LCSW

MEDICARE: SARAH HOPKINS SAMORE LCSW
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
1101Y00000XCounselor9407473-3501UT

General Provider Information

NPI Number : 1821574716
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH HOPKINS SAMORE LCSW
Provider Business Mailing Address
First Line : 669 E 9TH AVE
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84103-3610
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 925 E EXECUTIVE PARK DR STE B
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84117-3545
Country : US
Telephone Number : 801-590-9277
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2018
Last Update Date : 07/14/2018

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