Healthcare Provider Details

I. General information

NPI: 1083701338
Provider Name (Legal Business Name): ABBEY ROAD COUNSELING SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 W HARDING AVE STE C4
CEDAR CITY UT
84720-3091
US

IV. Provider business mailing address

66 W HARDING AVE STE C4
CEDAR CITY UT
84720-3091
US

V. Phone/Fax

Practice location:
  • Phone: 435-586-9521
  • Fax: 435-586-4268
Mailing address:
  • Phone: 435-586-9521
  • Fax: 435-586-4268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1283483501
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1283483501
License Number StateUT

VIII. Authorized Official

Name: GARY WAYNE MUNN
Title or Position: DIRECTOR
Credential: LCSW
Phone: 435-586-9521