Corrie Frances Agnew, LCSW

Individual provider Active NPI Clinical Social Worker · Salt Lake City, UT

NPI 1376976860 · NPPES record last updated Feb 27, 2024

Key facts

NPI
1376976860
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
7748697-3501 (UT)
Practice address
1945 S 1100 E
Suite 202
Salt Lake City, UT 84106-2369
Phone
(801) 657-0897
NPI assigned
Aug 20, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7748697-3501 UT Yes

Addresses

Primary practice location

1945 S 1100 E
Suite 202
Salt Lake City, UT 84106-2369

Mailing address

1049 S Pueblo St
Salt Lake City, UT 84104-3232
Phone (801) 388-8574

Other practice location 1

123 E Main St
Sandy, UT 84070-1509
Phone (801) 388-8574

Other providers in Salt Lake City, UT

All providers in Salt Lake City, UT · Clinical Social Worker in Utah

Sources for this page

Verify at the official NPI Registry.