Healthcare Provider Details

I. General information

NPI: 1659022705
Provider Name (Legal Business Name): CASSIDY CARTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CASSIDY GILPIN

II. Dates (important events)

Enumeration Date: 01/11/2022
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 E MAIN ST
SALINA UT
84654-1335
US

IV. Provider business mailing address

PO BOX 342
SALINA UT
84654-0342
US

V. Phone/Fax

Practice location:
  • Phone: 435-562-1866
  • Fax: 435-562-1866
Mailing address:
  • Phone: 435-562-1866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number132818323501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: