Provider Demographics
NPI:1710733589
Name:FAWCETT, AUBURN KATHLEEN (ACMHC, CRC)
Entity type:Individual
Prefix:
First Name:AUBURN
Middle Name:KATHLEEN
Last Name:FAWCETT
Suffix:
Gender:F
Credentials:ACMHC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 HERITAGE PARK BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-5645
Mailing Address - Country:US
Mailing Address - Phone:801-683-1062
Mailing Address - Fax:
Practice Address - Street 1:920 HERITAGE PARK BLVD STE 210
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-5645
Practice Address - Country:US
Practice Address - Phone:801-683-1062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-24
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13995551-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health