Provider Demographics
NPI:1659442952
Name:MCCAULEY, KAREN A (CMHC, MFT)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:A
Last Name:MCCAULEY
Suffix:
Gender:F
Credentials:CMHC, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 S 400 E
Mailing Address - Street 2:SUITE 330
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84111-2135
Mailing Address - Country:US
Mailing Address - Phone:801-440-8653
Mailing Address - Fax:
Practice Address - Street 1:124 S 400 E
Practice Address - Street 2:SUITE 330
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-2135
Practice Address - Country:US
Practice Address - Phone:801-440-8653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT59980736004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT59980736000001OtherBCBS OF UTAH PROVIDER ID