Provider Demographics
NPI:1427571645
Name:ATWOOD, CAIDY (CMHC)
Entity Type:Individual
Prefix:
First Name:CAIDY
Middle Name:
Last Name:ATWOOD
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4150 S 300 E APT 722
Mailing Address - Street 2:
Mailing Address - City:MILLCREEK
Mailing Address - State:UT
Mailing Address - Zip Code:84107-2417
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20 W MAIN STREET CT STE 200
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:UT
Practice Address - Zip Code:84004-1889
Practice Address - Country:US
Practice Address - Phone:385-387-1099
Practice Address - Fax:385-387-1243
Is Sole Proprietor?:No
Enumeration Date:2017-07-19
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10561270-6009101YM0800X
UT10561270-6004101YM0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program