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General NPI Number Information
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NPI Number | 1134875537
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Entity Type | Individual
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Provider Name | CHELSEA CARSON
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Gender | Female
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Dates
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Enumeration Date | 02/23/2022
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 240 MORRIS AVE STE 110
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City | SALT LAKE CITY
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State | UT
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Zip | 84115-3277
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Country | US
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Telephone | 801-935-4171
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Fax |
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Provider Business Mailing Address
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Address Line | 727 E 600 S APT 329
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City | SALT LAKE CITY
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State | UT
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Zip | 84102-4905
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Country | US
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Telephone | 972-750-2671
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 13157235-2501
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License Number State | UT
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