Provider Demographics
NPI:1073718805
Name:MARCROFT, KYNDEL (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KYNDEL
Middle Name:
Last Name:MARCROFT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11618 S STATE ST STE 1603
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-7123
Mailing Address - Country:US
Mailing Address - Phone:435-668-0832
Mailing Address - Fax:435-674-9380
Practice Address - Street 1:11618 S STATE ST STE 1603
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-7123
Practice Address - Country:US
Practice Address - Phone:801-796-2039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT377874-3501101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health