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

Kathy Wickersham

Individual provider Mental Health Counselor · NPI 1912156431

Kathy Wickersham is a Mental Health Counselor in Millcreek, Utah. Qualified in 2008, 18 years ago. Accepts Medicare assignment. Licensed in Utah.

Years since qualifying
18
Licensed in
UT
In the registry since
2008
Specialties on file
2
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Practice location Address checks out

1398 E Luck Ln
Millcreek, UT 84106-2944
Phone: (801) 251-6767
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 10570331-6004 (UT)
Case Manager/Care Coordinator Taxonomy 171M00000X

Record details

NPI number1912156431
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 9, 2008
Last updated in NPPESSeptember 20, 2022
Certification dateSeptember 20, 2022
Mailing address1877 S Wyoming St, Salt Lake City, UT 84108-3235

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Millcreek