Provider Demographics
NPI:1487114138
Name:GROICHER, KARA KRISTINE (ACMHC)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:KRISTINE
Last Name:GROICHER
Suffix:
Gender:F
Credentials:ACMHC
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:KRISTINE
Other - Last Name:CANTRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:525 E 100 S STE 320
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-4210
Mailing Address - Country:US
Mailing Address - Phone:801-587-3000
Mailing Address - Fax:
Practice Address - Street 1:525 E 100 S STE 320
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-4210
Practice Address - Country:US
Practice Address - Phone:801-587-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11121637-6009101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1740749415Medicaid