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General NPI Number Information
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NPI Number | 1528515798
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Entity Type | Individual
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Provider Name | CHRISTINA JEANNE JEFFERY CACKLER LCSW, MPH
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Gender | Female
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Dates
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Enumeration Date | 09/06/2016
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 7533 S CENTER VIEW CT STE N
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City | WEST JORDAN
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State | UT
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Zip | 84084-5526
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Country | US
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Telephone | 801-228-0927
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Fax |
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Provider Business Mailing Address
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Address Line | 7533 S CENTER VIEW CT STE N
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City | WEST JORDAN
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State | UT
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Zip | 84084-5526
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Country | US
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Telephone | 801-228-0927
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | ASW60571
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10999106-3501
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License Number State | UT
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