Provider Demographics
NPI:1659788446
Name:POPE, KAEL MCCADE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:KAEL
Middle Name:MCCADE
Last Name:POPE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4038 W LIBERTY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84009-9625
Mailing Address - Country:US
Mailing Address - Phone:435-233-0207
Mailing Address - Fax:
Practice Address - Street 1:8734 S 700 E STE 260
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-1801
Practice Address - Country:US
Practice Address - Phone:435-233-0207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-14
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8939679-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical