1558457481 NPI number — ANNE EVANS-CAZIER LCSW

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558457481 NPI number — ANNE EVANS-CAZIER LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EVANS-CAZIER
Provider First Name:
ANNE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BROWN
Provider Other First Name:
ANNE
Provider Other Middle Name:
EVANS
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1558457481
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/13/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1308 S 1700 E
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
SALT LAKE CITY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84108-2273
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-419-3312
Provider Business Mailing Address Fax Number:
801-907-7162

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1308 S 1700 E
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
SALT LAKE CITY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84108-2273
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-419-3312
Provider Business Practice Location Address Fax Number:
801-907-7162
Provider Enumeration Date:
10/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  5970882-3501 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2033511138AEC . This is a "EDUCATORS MUTUAL" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 59708823500001 . This is a "REGENCE BXBS" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".




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