MEDICARE: REBECCA PRICE 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
1	1041C0700X	Clinical Social Worker	13316058-3501	UT

General Provider Information

NPI Number	:	1386465581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA PRICE LCSW

Provider Business Mailing Address
First Line	:	1596 S 1300 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84105-2553
Country	:	US
Telephone Number	:	404-539-7560
Fax Number	:

Provider Business Practice Location Address
First Line	:	1596 S 1300 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84105-2553
Country	:	US
Telephone Number	:	404-539-7560
Fax Number	:

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

Provider Enumeration Date	:	10/21/2024
Last Update Date	:	10/21/2024

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Directions to “ REBECCA PRICE LCSW” Practice Location

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