Healthcare Provider Details

I. General information

NPI: 1669722583
Provider Name (Legal Business Name): NORTHERN UTAH COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2012
Last Update Date: 09/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1387 W 1800 N
CLINTON UT
84015-8942
US

IV. Provider business mailing address

3318A YORKTOWN ST
HILL AFB UT
84056-1443
US

V. Phone/Fax

Practice location:
  • Phone: 801-779-0095
  • Fax:
Mailing address:
  • Phone: 801-200-1945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JULIE LINDER
Title or Position: DIRECTOR
Credential:
Phone: 801-779-0095