Provider Demographics
NPI:1972730117
Name:BARCUS, CAROLYN G (EDD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:G
Last Name:BARCUS
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 455
Mailing Address - Street 2:7625 NORTH 1600 WEST
Mailing Address - City:SMITHFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84335-0455
Mailing Address - Country:US
Mailing Address - Phone:435-770-2780
Mailing Address - Fax:
Practice Address - Street 1:7625 N 1600 W
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:UT
Practice Address - Zip Code:84335-0455
Practice Address - Country:US
Practice Address - Phone:435-770-2780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-15
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT113033-2501103TC1900X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling