Healthcare Provider Details

I. General information

NPI: 1356780845
Provider Name (Legal Business Name): KARAN D PACE LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2013
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 E 4500 S STE 570
MURRAY UT
84107-4239
US

IV. Provider business mailing address

310 E 4500 S STE 570
MURRAY UT
84107-4239
US

V. Phone/Fax

Practice location:
  • Phone: 801-262-9619
  • Fax: 801-262-9630
Mailing address:
  • Phone: 801-262-9619
  • Fax: 801-262-9630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number127363-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: