Healthcare Provider Details

I. General information

NPI: 1255818233
Provider Name (Legal Business Name): R&K MARCROFT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2018
Last Update Date: 11/03/2023
Certification Date: 11/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11618 S STATE ST STE 1604
DRAPER UT
84020-7123
US

IV. Provider business mailing address

11618 S STATE ST STE 1603
DRAPER UT
84020-7123
US

V. Phone/Fax

Practice location:
  • Phone: 801-988-9807
  • Fax: 801-930-5739
Mailing address:
  • Phone: 435-668-0832
  • Fax: 801-930-5739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number377874-3501
License Number StateUT

VII. Legacy identifiers

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

VIII. Authorized Official

Name: MRS. KYNDEL MARCROFT
Title or Position: OWNER
Credential: LCSW
Phone: 435-668-0832