Individual
HEATHER ANNA WHITEHEAD-SAMPINOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W
Contact information
Practice address
2500 S STATE ST, SOUTH SALT LAKE, UT 84115-3164
(385) 646-0569
Mailing address
1839 E 2100 S, SALT LAKE CITY, UT 84106-4166
(801) 598-4935
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
128651-3501
UT
1041S0200X
School Social Worker
Primary
128651-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12865135000001
BLUE CROSS
UT
Enumeration date
03/24/2006
Last updated
05/24/2022
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