Healthcare Provider Details

I. General information

NPI: 1609947712
Provider Name (Legal Business Name): JOYCE ARLENE KELEN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 E 900 S SUITE 26
SALT LAKE CITY UT
84105-1401
US

IV. Provider business mailing address

128 M ST
SALT LAKE CITY UT
84103-3854
US

V. Phone/Fax

Practice location:
  • Phone: 801-537-7523
  • Fax: 801-363-9022
Mailing address:
  • Phone: 801-322-3117
  • Fax: 801-363-9022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number119968-3501
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: