Provider Demographics
NPI:1083699565
Name:VARLEY, SANDRA KAY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:KAY
Last Name:VARLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SANDY
Other - Middle Name:
Other - Last Name:VARLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1141 E 3900 S
Mailing Address - Street 2:SUITE A-170
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-1215
Mailing Address - Country:US
Mailing Address - Phone:801-284-4990
Mailing Address - Fax:801-284-4991
Practice Address - Street 1:1141 E 3900 S
Practice Address - Street 2:SUITE A-170
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-1215
Practice Address - Country:US
Practice Address - Phone:801-284-4990
Practice Address - Fax:801-284-4991
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT130458-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTU0006OtherINTRMTN. HEALTH CARE
UTU0002OtherDESERET MUTUAL
UTU003OtherEDUCATORS MUTUAL
UTU003OtherEDUCATORS MUTUAL