Healthcare Provider Details

I. General information

NPI: 1154162030
Provider Name (Legal Business Name): OPEN BOOK COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2024
Last Update Date: 10/23/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

949 E 12400 S STE A2
DRAPER UT
84020-9333
US

IV. Provider business mailing address

949 E 12400 S STE A2
DRAPER UT
84020-9333
US

V. Phone/Fax

Practice location:
  • Phone: 801-821-8176
  • Fax:
Mailing address:
  • Phone: 801-821-8176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MR. SCOTT FRAZIER
Title or Position: OWNER
Credential: CMHC
Phone: 801-821-8176