Healthcare Provider Details

I. General information

NPI: 1235033390
Provider Name (Legal Business Name): CARSON FIELD LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

669 S 510 E
KAYSVILLE UT
84037-2696
US

IV. Provider business mailing address

669 S 510 E
KAYSVILLE UT
84037-2696
US

V. Phone/Fax

Practice location:
  • Phone: 507-461-5575
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13453350-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: