Carmack, Derek Benjamin

Carmack, Derek Benjamin is an individual health care provider with primary practice located at 750 N Freedom Blvd , Provo UT 84601-1677. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Peer Specialist, Student, Health Care / Student in an Organized Health Care Education/Training Program, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Carmack, Derek Benjamin can be contacted via phone (801) 373-4760.

Contact Information

Primary practice address
750 N Freedom Blvd Provo UT 84601-1677
Phone: (801) 373-4760
Fax: (801) 373-0639
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X 884 Utah
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X 12267033-3502 Utah

Profile Details

NPI number 1730653254
LBN Legal business name Carmack, Derek Benjamin
Credentials CPSS, CSW
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2019
Last updated Jul 20th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers