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NPI Code Detail

MEDICARE: MARY ANN CARTER LCSW

MEDICARE: MARY ANN CARTER 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 Worker59096603502UT
21041C0700XClinical Social Worker5909660-3501UT

General Provider Information

NPI Number : 1518926880
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY ANN CARTER LCSW
Provider Business Mailing Address
First Line : 1936 W 140 S
Second Line :
City : OREM
State : UT
Zip : 84059-2663
Country : US
Telephone Number : 801-318-8634
Fax Number : 801-377-0930
Provider Business Practice Location Address
First Line : 286 S 600 E STE C
Second Line :
City : PROVO
State : UT
Zip : 84606-4780
Country : US
Telephone Number : 801-318-8634
Fax Number : 801-377-0930
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2006
Last Update Date : 03/15/2019

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Directions to “ MARY ANN CARTER LCSW” Practice Location

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