Provider Demographics
NPI:1063892339
Name:LOGAN, CARA (LCSW)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:LOGAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1664 S DIXIE DR
Mailing Address - Street 2:C-102
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-7327
Mailing Address - Country:US
Mailing Address - Phone:435-673-4494
Mailing Address - Fax:
Practice Address - Street 1:1664 S DIXIE DR
Practice Address - Street 2:C-102
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-7327
Practice Address - Country:US
Practice Address - Phone:435-673-4494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-02
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8819051-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical