Healthcare Provider Details

I. General information

NPI: 1184237711
Provider Name (Legal Business Name): CAITLIN NICOLE BAILEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2020
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 E 5900 S STE A106
MURRAY UT
84107-7268
US

IV. Provider business mailing address

4162 S SHAKEDOWN ST # R-113
MILLCREEK UT
84107-2043
US

V. Phone/Fax

Practice location:
  • Phone: 801-505-9159
  • Fax:
Mailing address:
  • Phone: 801-505-9159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12826361-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: