Healthcare Provider Details

I. General information

NPI: 1700575156
Provider Name (Legal Business Name): MRS. KAREN M RICHARDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2023
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 N MAIN ST STE 206
BOUNTIFUL UT
84010-6153
US

IV. Provider business mailing address

931 N DAVIS BLVD
BOUNTIFUL UT
84010-1735
US

V. Phone/Fax

Practice location:
  • Phone: 801-687-5305
  • Fax:
Mailing address:
  • Phone: 801-687-5305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13998685-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: