MEDICARE: MR. PADEN SPENCE CARTER MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1043929524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PADEN SPENCE CARTER MA

Provider Business Mailing Address
First Line	:	440 S 500 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-2705
Country	:	US
Telephone Number	:	801-935-4162
Fax Number	:

Provider Business Practice Location Address
First Line	:	434 S 500 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-8410
Country	:	US
Telephone Number	:	801-359-8862
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2022
Last Update Date	:	11/23/2022

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Directions to “ MR. PADEN SPENCE CARTER MA” Practice Location

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