Provider Demographics
NPI:1396896858
Name:KINIKINI, KARSON SATEKI (CMHC)
Entity type:Individual
Prefix:MR
First Name:KARSON
Middle Name:SATEKI
Last Name:KINIKINI
Suffix:
Gender:M
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:498 N 900 W STE 200
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-4153
Mailing Address - Country:US
Mailing Address - Phone:801-525-4645
Mailing Address - Fax:801-779-7808
Practice Address - Street 1:498 N 900 W STE 200
Practice Address - Street 2:
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037-4153
Practice Address - Country:US
Practice Address - Phone:801-525-4645
Practice Address - Fax:801-779-7808
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT376686-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health