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

Kallie Petersen, LCSW

Individual provider Clinical Social Worker · NPI 1548959968

Kallie Petersen, LCSW is a Clinical Social Worker in Salt Lake City, Utah. Licensed in Utah. Registered with an NPI since 2023.

Licensed in
UT
In the registry since
2023
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone: (801) 828-6150
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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 8533533-3501 (UT)

Record details

NPI number1548959968
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedMay 2, 2023
Last updated in NPPESMay 2, 2023
Certification dateApril 28, 2023

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