MEDICARE: MS. SHERRY KAYE GRIFFITH 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	1451273501	UT

General Provider Information

NPI Number	:	1992781033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHERRY KAYE GRIFFITH LCSW

Provider Business Mailing Address
First Line	:	3809 W 6200 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84118-3725
Country	:	US
Telephone Number	:	801-963-4395
Fax Number	:

Provider Business Practice Location Address
First Line	:	3809 W 6200 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84118-3725
Country	:	US
Telephone Number	:	801-963-4395
Fax Number	:

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

Provider Enumeration Date	:	12/20/2005
Last Update Date	:	03/17/2008

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