Carol Bourne, BHCM
Individual provider Active NPI Case Manager/Care Coordinator · Tooele, UT
NPI 1376404186 · NPPES record last updated Nov 20, 2025
Key facts
- NPI
- 1376404186
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- License
- F25-128534 (UT)
- Practice address
- 60 S Main St Ste 5
Tooele, UT 84074-2168 - Phone
- (435) 255-6150
- Fax
- (707) 628-9861
- NPI assigned
- Nov 20, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F25-128534 | UT | MD | Case Manager/Care Coordinator |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | F25-128534 | UT | Yes |
Addresses
Primary practice location
60 S Main St Ste 5
Tooele, UT 84074-2168
Mailing address
469 Havasu St
Tooele, UT 84074-1519
Phone (435) 255-6150
Other providers in Tooele, UT
- Alyssa Bohn
- Amanda Bonacorso
- Bonneville Mental Health
- Bonneville Mental Health, PLLC
- Kimball Booth
- Jessica E Bowen
- Randall Bown
- Anndrea M Boyer
- Christine Melissa Winder Bradbury
- Paula Stockman Bradley
All providers in Tooele, UT · Case Manager/Care Coordinator in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.