MEDICARE: CARRIE L LOSIN 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

General Provider Information

NPI Number	:	1710788500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE L LOSIN LCSW

Provider Business Mailing Address
First Line	:	1469 N 1200 W
Second Line	:
City	:	OREM
State	:	UT
Zip	:	84057-2449
Country	:	US
Telephone Number	:	801-655-5450
Fax Number	:	385-225-9327

Provider Business Practice Location Address
First Line	:	7101 N GREEN BAY AVE STE 11
Second Line	:
City	:	GLENDALE
State	:	WI
Zip	:	53209-2800
Country	:	US
Telephone Number	:	801-655-5450
Fax Number	:	385-225-9327

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

Provider Enumeration Date	:	03/19/2025
Last Update Date	:	03/19/2025

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Directions to “ CARRIE L LOSIN LCSW” Practice Location

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