Organization
SALT LAKE COUNTY FOR ITS YOUTH SERVICES DIVISION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROLYN HANSEN LCSW (DIVISION DIRECTOR)
(385) 468-4501
Entity
Organization
Contact information
Practice address
177 WEST PRICE AVE, SOUTH SALT LAKE CITY, UT 84115-4345
(801) 269-7500
(801) 269-7550
Mailing address
2001 SOUTH STATE STREET, SUITE N4100, SALT LAKE CITY, UT 84190-1021
(801) 468-2332
(801) 468-3712
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1169286004
UT
101YA0400X
Addiction (Substance Use Disorder) Counselor
3470473502
UT
101YA0400X
Addiction (Substance Use Disorder) Counselor
47632166004
UT
101YA0400X
Addiction (Substance Use Disorder) Counselor
56931903502
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HT0004001
—
UT
01
—
HT002258
UTAH HEALTH
UT
Enumeration date
04/23/2007
Last updated
05/08/2012
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