Provider Demographics
NPI:1780074195
Name:BARKER, AUTUMN (ACMHC)
Entity type:Individual
Prefix:
First Name:AUTUMN
Middle Name:
Last Name:BARKER
Suffix:
Gender:F
Credentials:ACMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4091 W 12600 S STE 200
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84096-7302
Mailing Address - Country:US
Mailing Address - Phone:801-217-9600
Mailing Address - Fax:
Practice Address - Street 1:4091 W 12600 S STE 200
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84096-7302
Practice Address - Country:US
Practice Address - Phone:801-217-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-23
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9226431-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health