Healthcare Provider Details

I. General information

NPI: 1063892339
Provider Name (Legal Business Name): CARA ADRIAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2015
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 FOOTHILL BLVD
SALT LAKE CITY UT
84148-0001
US

IV. Provider business mailing address

500 FOOTHILL BLVD
SALT LAKE CITY UT
84148-0001
US

V. Phone/Fax

Practice location:
  • Phone: 435-673-4494
  • Fax:
Mailing address:
  • Phone: 435-673-4494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8819051-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: