Provider Demographics
NPI:1538440474
Name:BUFFI, CAROL ELAINE (LCSW)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:ELAINE
Last Name:BUFFI
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 1:3311 S 4985 W
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84120-1700
Mailing Address - Country:US
Mailing Address - Phone:801-703-7911
Mailing Address - Fax:866-614-0752
Practice Address - Street 1:2832 W 4700 S
Practice Address - Street 2:SUITE A
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84129-2155
Practice Address - Country:US
Practice Address - Phone:801-703-7911
Practice Address - Fax:866-614-0752
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT35172435011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical