Healthcare Provider Details

I. General information

NPI: 1336928894
Provider Name (Legal Business Name): KASEY TRIMBLE ACMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2023
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 N OREM BLVD
OREM UT
84057-6601
US

IV. Provider business mailing address

822 S 1040 W
PAYSON UT
84651-4614
US

V. Phone/Fax

Practice location:
  • Phone: 801-609-2448
  • Fax: 801-609-2447
Mailing address:
  • Phone: 801-609-2448
  • Fax: 801-609-2447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13466607-6009
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: