| Millcreek Therapy Psychological Services | |
|
1398 E Luck Ln Millcreek UT 84106-2944 | |
| (801) 870-3716 | |
| Not Available |
| Full Name | Millcreek Therapy Psychological Services |
|---|---|
| Speciality | Social Worker |
| Location | 1398 E Luck Ln, Millcreek, Utah |
| Authorized Official Name and Position | Nancy Kimmerly (OWNER / LCSW) |
| Authorized Official Contact | 8018703716 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Millcreek Therapy Psychological Services 1398 E Luck Ln Millcreek UT 84106-2944 Ph: () - | Millcreek Therapy Psychological Services 1398 E Luck Ln Millcreek UT 84106-2944 Ph: (801) 870-3716 |
| NPI Number | 1033811401 |
|---|---|
| Provider Enumeration Date | 03/20/2023 |
| Last Update Date | 10/17/2023 |
| Certification Date | 10/17/2023 |
| Medicare PECOS PAC ID | 1759736549 |
|---|---|
| Medicare Enrollment ID | O20231013002980 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033811401 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Nancy Kimmerly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548752264 PECOS PAC ID: 2264869247 Enrollment ID: I20200304001359 |
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