Individual
MS. CAROLIE MECCICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
5315 SOUTH ADAMS AVE., SUITE B7, WASHINGTON TERRACE, UT 84405-4509
(801) 528-5054
(801) 479-3997
Mailing address
5315 SOUTH ADAMS AVE., SUITE B7, WASHINGTON TERRACE, UT 84405-4509
(801) 528-5054
(801) 479-3997
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2766013501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2766013501
STATE OF UTAH LICENSE #
UT
Enumeration date
04/19/2006
Last updated
07/08/2007
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