Provider Demographics
NPI:1215319686
Name:ATKINSON, CHRISTY (LCSW)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:R
Other - Last Name:WILCOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:525 E 100 S
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SLC
Mailing Address - State:UT
Mailing Address - Zip Code:84102-4210
Mailing Address - Country:US
Mailing Address - Phone:801-389-9997
Mailing Address - Fax:
Practice Address - Street 1:525 E 100 S
Practice Address - Street 2:SUITE 120
Practice Address - City:SLC
Practice Address - State:UT
Practice Address - Zip Code:84102-4210
Practice Address - Country:US
Practice Address - Phone:801-389-9997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8427479-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical