Provider Demographics
NPI:1043829328
Name:PACE, CHRISTOPHER WESLEY (LCSW)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:WESLEY
Last Name:PACE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:PACE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:937 S 400 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84111-4313
Mailing Address - Country:US
Mailing Address - Phone:801-671-7223
Mailing Address - Fax:
Practice Address - Street 1:2000 CIRCLE OF HOPE DR RM 2840
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84112-5550
Practice Address - Country:US
Practice Address - Phone:801-671-7223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6344763-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical