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Organization

KDC PSYCHOTHERAPY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHRYN W CARPENTER LCSW (LCSW/OWNER)
(801) 244-2320
Entity
Organization

Contact information

Practice address
850 E 300 S STE 5, SALT LAKE CITY, UT 84102-2394
(801) 244-2320
Mailing address
850 E 300 S STE 5, SALT LAKE CITY, UT 84102-2394
(801) 244-2320

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
89573553501
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
89573553501
STATE LICENSE
UT
Enumeration date
02/09/2018
Last updated
05/02/2018
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