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General NPI Number Information
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NPI Number | 1043662968
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Entity Type | Individual
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Provider Name | CHRISTIE L. MCDERMOTT MS
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Gender | Female
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Dates
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Enumeration Date | 07/02/2016
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Last Update Date | 12/14/2024
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Provider Practice Location Address
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Address Line | 463 W CIMARRON AVE
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City | SARATOGA SPRINGS
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State | UT
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Zip | 84045-6535
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Country | US
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Telephone | 509-939-0204
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Fax |
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Provider Business Mailing Address
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Address Line | 463 W CIMARRON AVE
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City | SARATOGA SPRINGS
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State | UT
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Zip | 84045-6535
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Country | US
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Telephone | 509-939-0204
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 60845527
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 11567274-6004
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CP0305
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License Number State | NV
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