Provider Demographics
NPI:1992272629
Name:WARD, CARRA M (CMHCI)
Entity type:Individual
Prefix:
First Name:CARRA
Middle Name:M
Last Name:WARD
Suffix:
Gender:F
Credentials:CMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 N 200 W
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-7043
Mailing Address - Country:US
Mailing Address - Phone:801-815-3443
Mailing Address - Fax:801-683-8962
Practice Address - Street 1:920 NORTH 000 WEST
Practice Address - Street 2:
Practice Address - City:MANTI
Practice Address - State:UT
Practice Address - Zip Code:84642-8464
Practice Address - Country:US
Practice Address - Phone:435-851-7483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional