Healthcare Provider Details

I. General information

NPI: 1316512064
Provider Name (Legal Business Name): CAROL DREW EREKSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2021
Last Update Date: 11/09/2025
Certification Date: 11/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1921 E STAG HILL CIR
DRAPER UT
84020-8348
US

IV. Provider business mailing address

1921 E STAG HILL CIR
DRAPER UT
84020-8348
US

V. Phone/Fax

Practice location:
  • Phone: 385-327-3936
  • Fax:
Mailing address:
  • Phone: 385-327-3936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13525557-3501
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: