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NPI Code Detail

MEDICARE: AMBER WHITAKER LCSW

MEDICARE: AMBER WHITAKER LCSW
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
11041C0700XClinical Social Worker13986682-3501UT

General Provider Information

NPI Number : 1093644395
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER WHITAKER LCSW
Provider Business Mailing Address
First Line : 1924 W HOMESTEAD FARMS LN APT 3
Second Line :
City : WEST VALLEY CITY
State : UT
Zip : 84119-6175
Country : US
Telephone Number : 801-581-2169
Fax Number : 801-581-8462
Provider Business Practice Location Address
First Line : 955 W 3300 S
Second Line :
City : SOUTH SALT LAKE
State : UT
Zip : 84119-3325
Country : US
Telephone Number : 801-587-3631
Fax Number : 801-587-3631
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2026
Last Update Date : 05/14/2026

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