Healthcare Provider Details

I. General information

NPI: 1184336851
Provider Name (Legal Business Name): KAELAN ALLAN PARKER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAELAN ALLAN

II. Dates (important events)

Enumeration Date: 12/14/2022
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 E 3900 S STE 200
SALT LAKE CITY UT
84124-1766
US

IV. Provider business mailing address

1433 N 1200 W
OREM UT
84057-2449
US

V. Phone/Fax

Practice location:
  • Phone: 801-655-5450
  • Fax: 385-225-9327
Mailing address:
  • Phone: 801-655-5450
  • Fax: 385-225-9327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12236509-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: