Healthcare Provider Details

I. General information

NPI: 1942052097
Provider Name (Legal Business Name): SATHIYANATHAN COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2024
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 N MAIN ST STE 206
BOUNTIFUL UT
84010-6153
US

IV. Provider business mailing address

855 S 3050 W
SYRACUSE UT
84075-5127
US

V. Phone/Fax

Practice location:
  • Phone: 801-896-3505
  • Fax: 844-583-1354
Mailing address:
  • Phone: 801-896-3505
  • Fax: 844-583-1354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. NISHA MARIA SATHIYANATHAN
Title or Position: CEO
Credential: LCSW
Phone: 801-896-3505