Healthcare Provider Details

I. General information

NPI: 1528293495
Provider Name (Legal Business Name): SARAH ANNE CASPER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. SARAH ANNE BOLICK

II. Dates (important events)

Enumeration Date: 05/21/2009
Last Update Date: 08/30/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2317 N HILL FIELD RD STE 103
LAYTON UT
84041-4782
US

IV. Provider business mailing address

2317 N HILL FIELD RD STE 103
LAYTON UT
84041-4782
US

V. Phone/Fax

Practice location:
  • Phone: 801-913-1212
  • Fax:
Mailing address:
  • Phone: 801-913-1212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7431838-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: