MEDICARE: CHRISTINA MCKELL 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
1	1041S0200X	School Social Worker

General Provider Information

NPI Number	:	1962905646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA MCKELL LCSW

Provider Business Mailing Address
First Line	:	4403 S 2950 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84124-3740
Country	:	US
Telephone Number	:	801-792-2404
Fax Number	:

Provider Business Practice Location Address
First Line	:	4403 S 2950 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84124-3740
Country	:	US
Telephone Number	:	801-792-2404
Fax Number	:

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

Provider Enumeration Date	:	03/09/2018
Last Update Date	:	09/11/2025

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Directions to “ CHRISTINA MCKELL LCSW” Practice Location

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