Provider Demographics
NPI:1992682157
Name:MOORE, CARRIE (CMHC INTERN)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:MOORE
Suffix:
Gender:F
Credentials:CMHC INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9584 S ROYAL HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-3460
Mailing Address - Country:US
Mailing Address - Phone:801-560-0032
Mailing Address - Fax:
Practice Address - Street 1:3002 W 12600 S
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84065-7119
Practice Address - Country:US
Practice Address - Phone:801-930-0411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health