| Kdc Psychotherapy Llc | |
|
850 E 300 S Ste 5 Salt Lake City UT 84102-2394 | |
| (801) 244-2320 | |
| Not Available |
| Full Name | Kdc Psychotherapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 850 E 300 S Ste 5, Salt Lake City, Utah |
| Authorized Official Name and Position | Kathryn W Carpenter (LCSW/OWNER) |
| Authorized Official Contact | 8012442320 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kdc Psychotherapy Llc 850 E 300 S Ste 5 Salt Lake City UT 84102-2394 Ph: (801) 244-2320 | Kdc Psychotherapy Llc 850 E 300 S Ste 5 Salt Lake City UT 84102-2394 Ph: (801) 244-2320 |
| NPI Number | 1215436712 |
|---|---|
| Provider Enumeration Date | 02/09/2018 |
| Last Update Date | 05/02/2018 |
| Medicare PECOS PAC ID | 6002171568 |
|---|---|
| Medicare Enrollment ID | O20180604001643 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215436712 | NPI | - | NPPES |
| 89573553501 | Other | UT | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 89573553501 (Utah) | Primary |
| Provider Name | Kathryn Williams Dennett Carpenter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093266876 PECOS PAC ID: 7810277944 Enrollment ID: I20161207002320 |
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