Provider Demographics
NPI:1710788500
Name:LOSIN, CARRIE L (LCSW)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:L
Last Name:LOSIN
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 1:1469 N 1200 W
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-2449
Mailing Address - Country:US
Mailing Address - Phone:801-655-5450
Mailing Address - Fax:385-225-9327
Practice Address - Street 1:7101 N GREEN BAY AVE STE 11
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53209-2800
Practice Address - Country:US
Practice Address - Phone:801-655-5450
Practice Address - Fax:385-225-9327
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical