Katrina M Gardner, LCSW

Individual provider Active NPI Clinical Social Worker · Cedar Hills, UT

NPI 1992591440 · NPPES record last updated Apr 18, 2025

Key facts

NPI
1992591440
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
11544546-3501 (UT)
Practice address
4457 W Bridgestone Dr
Cedar Hills, UT 84062-7723
Phone
(305) 772-4159
Fax
(305) 772-4159
NPI assigned
Apr 18, 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

LicenseStateTypeSpecialty
11544546-3501UTMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 11544546-3501 UT Yes

Addresses

Primary practice location

4457 W Bridgestone Dr
Cedar Hills, UT 84062-7723

Mailing address

165 S 1000 E
Salt Lake City, UT 84102-1402
Phone (305) 772-4159

Other providers in Cedar Hills, UT

All providers in Cedar Hills, UT · Clinical Social Worker in Utah

Sources for this page

Verify at the official NPI Registry.