Provider Demographics
NPI:1427038090
Name:MOGZEC, SARAH OSWALD (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:OSWALD
Last Name:MOGZEC
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 1:1042 RAMONA AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-3412
Mailing Address - Country:US
Mailing Address - Phone:801-487-4320
Mailing Address - Fax:
Practice Address - Street 1:1020 S MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84101-3194
Practice Address - Country:US
Practice Address - Phone:801-539-7000
Practice Address - Fax:801-539-7050
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT26998135011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT107012407101OtherINTRMTN. HEALTH CARE
UT942938348MOGOtherEDUCATORS MUTUAL
UT751646OtherDESERET MUTUAL
UT107012407101OtherINTRMTN. HEALTH CARE
UT751646OtherDESERET MUTUAL