Provider Demographics
NPI:1750679445
Name:SWENSON, KARIE (MA, CTRS)
Entity Type:Individual
Prefix:MS
First Name:KARIE
Middle Name:
Last Name:SWENSON
Suffix:
Gender:F
Credentials:MA, CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 IDAHO AVE
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84606-5236
Mailing Address - Country:US
Mailing Address - Phone:801-669-1021
Mailing Address - Fax:
Practice Address - Street 1:420 IDAHO AVE
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84606-5236
Practice Address - Country:US
Practice Address - Phone:801-669-1021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT105035-4002101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor