David Cacamis

Individual provider Active NPI Clinical Social Worker · Enterprise, UT

NPI 1801555461 · NPPES record last updated Dec 10, 2021

Key facts

NPI
1801555461
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
10922062-3501 (UT)
Practice address
709 East Main St.
Enterprise, UT 84725-8410
Phone
(435) 236-7577
NPI assigned
Dec 10, 2021
Sex
Male
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

LicenseStateTypeSpecialty
10922062-3501UTMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 10922062-3501 UT Yes

Addresses

Primary practice location

709 East Main St.
Enterprise, UT 84725-8410

Mailing address

PO Box 1027
Enterprise, UT 84725-1027

Other identifiers

IdentifierTypeStateIssuer
10922062-3501OtherUTDEPARTMENT OF PROFESSIONAL LICENSING

Other providers in Enterprise, UT

All providers in Enterprise, UT · Clinical Social Worker in Utah

Sources for this page

Verify at the official NPI Registry.