Provider Demographics
NPI:1184681918
Name:CRIST, KAREN J (LCSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:J
Last Name:CRIST
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 1:1399 S 7TH E
Mailing Address - Street 2:SUITE #5
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-2149
Mailing Address - Country:US
Mailing Address - Phone:801-484-4377
Mailing Address - Fax:
Practice Address - Street 1:1399 S 7TH E
Practice Address - Street 2:SUITE #5
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105-2149
Practice Address - Country:US
Practice Address - Phone:801-484-4377
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT141437-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical