MEDICARE: AMBER HALL CSW

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	12338800-3502	UT

General Provider Information

NPI Number	:	1275403065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER HALL CSW

Provider Business Mailing Address
First Line	:	1521 E 3900 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84124-1501
Country	:	US
Telephone Number	:	801-268-3800
Fax Number	:

Provider Business Practice Location Address
First Line	:	1521 E 3900 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84124-1501
Country	:	US
Telephone Number	:	801-268-3800
Fax Number	:

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

Provider Enumeration Date	:	11/07/2025
Last Update Date	:	11/07/2025

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Directions to “ AMBER HALL CSW” Practice Location

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