Provider Demographics
NPI:1780574889
Name:PARKINSON, KASIDI LEE
Entity type:Individual
Prefix:
First Name:KASIDI
Middle Name:LEE
Last Name:PARKINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2660 W 3900 N
Mailing Address - Street 2:
Mailing Address - City:FARR WEST
Mailing Address - State:UT
Mailing Address - Zip Code:84404-4606
Mailing Address - Country:US
Mailing Address - Phone:801-725-2816
Mailing Address - Fax:
Practice Address - Street 1:1812 N 2000 W
Practice Address - Street 2:SUITE 5
Practice Address - City:FARR WEST
Practice Address - State:UT
Practice Address - Zip Code:84404
Practice Address - Country:US
Practice Address - Phone:801-605-3086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13196997-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health