Provider Demographics
NPI:1508253667
Name:SEARLE, KATHY (CSW)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:SEARLE
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 W CHESAPEAKE CIR
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84123-4907
Mailing Address - Country:US
Mailing Address - Phone:801-266-4911
Mailing Address - Fax:
Practice Address - Street 1:785 W CHESAPEAKE CIR
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84123-4907
Practice Address - Country:US
Practice Address - Phone:801-266-4911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-16
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6892138-3502104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker