MEDICARE: FAR SKY HEALING

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1114612660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAR SKY HEALING

Provider Business Mailing Address
First Line	:	1260 E GILMER DR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84105-1527
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4055 S 700 E STE 101G
Second Line	:
City	:	MILLCREEK
State	:	UT
Zip	:	84107-2508
Country	:	US
Telephone Number	:	385-645-0566
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CARRIE GAYKOWSKI
Credential	:	LCSW
Telephone Number	:	801-450-2592

Provider Enumeration Date	:	04/10/2023
Last Update Date	:	06/01/2023

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Directions to “FAR SKY HEALING ” Practice Location

Language	Start Address	Practice Location

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