Healthcare Provider Details

I. General information

NPI: 1346739182
Provider Name (Legal Business Name): KIRSTEN GREENFIELD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2018
Last Update Date: 10/26/2025
Certification Date: 10/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

274 N MAIN ST
LOGAN UT
84321-3915
US

IV. Provider business mailing address

425 N 600 W
SMITHFIELD UT
84335-4766
US

V. Phone/Fax

Practice location:
  • Phone: 435-213-9278
  • Fax:
Mailing address:
  • Phone: 908-731-2880
  • Fax: 801-373-0639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12317492-3501
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: