Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Derek Benjamin Carmack, CPSS, CSW

Individual provider Peer Specialist · NPI 1730653254

Derek Benjamin Carmack, CPSS, CSW is a Clinical Social Worker in Provo, Utah. Qualified in 2021, 5 years ago. Practices with Wasatch Behavioral Health Special Service District, a 82-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
5
Licensed in
UT
In the registry since
2019
Specialties on file
3
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Practice location Address checks out

750 N Freedom Blvd
Provo, UT 84601-1677
Phone: (801) 373-4760
Fax: (801) 373-0639
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 12267033-3502 (UT)
Peer Specialist Taxonomy 175T00000X · Licence 884 (UT)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1730653254
Entity typeIndividual (Type 1)
GenderMale
Credentials CPSS , CSW
Sole proprietorNo
NPI enumeratedJanuary 17, 2019
Last updated in NPPESJuly 20, 2021
Certification dateJuly 20, 2021
Mailing address750 N Freedom Blvd, Provo, UT 84601-1677

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Wasatch Behavioral Health Special Service District — 82 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Provo