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NPI Code Detail

MEDICARE: CARRIE ANN JUDD MSW, LCSW

MEDICARE: CARRIE ANN JUDD MSW, 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 Worker12224259-3502UT
21041C0700XClinical Social Worker13941924-3501UT

General Provider Information

NPI Number : 1952048753
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARRIE ANN JUDD MSW, LCSW
Provider Business Mailing Address
First Line : 331 S 600 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84102-4013
Country : US
Telephone Number : 801-210-1197
Fax Number :
Provider Business Practice Location Address
First Line : 331 S 600 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84102-4013
Country : US
Telephone Number : 801-210-1197
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2022
Last Update Date : 05/10/2024

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