KATHY WICKERSHAM NPI 1912156431

NPI Information

  • NPI: 1912156431
  • Provider Name: KATHY WICKERSHAM
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1398 E LUCK LN
    MILLCREEK, UT
    ZIP 84106
  • Phone: (801) 251-6767

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NPI Details

Kathy Wickersham is a mental health counselor in Millcreek, UT with 18 years of experience. Kathy Wickersham NPI is 1912156431. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1398 E LUCK LN
MILLCREEK, UT
ZIP 84106-944
Phone: (801) 251-6767

The NPI 1912156431 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 9/9/2008 and was last updated on 9/20/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental Health10570331-6004UTAHYes
2171M00000XCase Manager/Care CoordinatorNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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