Provider Demographics
NPI:1114336617
Name:CHECKETTS, KAREN (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:CHECKETTS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 ALBION VILLAGE WAY
Mailing Address - Street 2:303
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-5601
Mailing Address - Country:US
Mailing Address - Phone:801-520-4917
Mailing Address - Fax:801-838-7607
Practice Address - Street 1:9035 S 1300 E
Practice Address - Street 2:B120
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-3132
Practice Address - Country:US
Practice Address - Phone:801-838-7606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-08
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5080319-2501103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling