MEDICARE: HEALTH & WELL-BEING KALEIDOSCOPE OF CREATIVE HEALING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1386223113
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH & WELL-BEING KALEIDOSCOPE OF CREATIVE HEALING

Provider Business Mailing Address
First Line	:	2341 GUARDIAN CIR
Second Line	:
City	:	SAINT GEORGE
State	:	UT
Zip	:	84790-8055
Country	:	US
Telephone Number	:	435-773-8584
Fax Number	:

Provider Business Practice Location Address
First Line	:	2341 GUARDIAN CIR
Second Line	:
City	:	SAINT GEORGE
State	:	UT
Zip	:	84790-8055
Country	:	US
Telephone Number	:	435-313-4051
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LANI CHIPMAN
Credential	:	LMFT
Telephone Number	:	435-773-8584

Provider Enumeration Date	:	04/07/2021
Last Update Date	:	07/12/2024

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Directions to “HEALTH & WELL-BEING KALEIDOSCOPE OF CREATIVE HEALING ” Practice Location

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