Kenison, Evan T

Kenison, Evan T is an individual health care provider with primary practice located at 100 S 1000 W , Tooele UT 84074-4010. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Kenison, Evan T can be contacted via phone (435) 843-3520.

Contact Information

Primary practice address
100 S 1000 W Tooele UT 84074-4010
Phone: (435) 843-3520
Fax: (435) 843-3555
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 3099283501 Utah

Profile Details

NPI number 1912977505
LBN Legal business name Kenison, Evan T
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2006
Last updated Aug 8th, 2019 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912977505 NPPES
Utah Other 832612 DESERET MUTUAL
Utah Other 942938348 DESERET MUTUAL
Utah Other 942938348EVK DESERET MUTUAL
Utah Other 107029553101 DESERET MUTUAL

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