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NPI Code Detail

MEDICARE: KIMBERLY WALDEN BARRUS LCSW

MEDICARE: KIMBERLY WALDEN BARRUS 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
1104100000XSocial Worker6221757-3502UT
21041C0700XClinical Social Worker6221757-3501UT

General Provider Information

NPI Number : 1790879625
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY WALDEN BARRUS LCSW
Provider Business Mailing Address
First Line : PO BOX 27128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0128
Country : US
Telephone Number : 801-387-5600
Fax Number :
Provider Business Practice Location Address
First Line : 3903 MEDICAL DR STE 300
Second Line :
City : OGDEN
State : UT
Zip : 84403-2317
Country : US
Telephone Number : 801-387-5600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 04/17/2026

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Directions to “ KIMBERLY WALDEN BARRUS LCSW” Practice Location

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