Healthcare Provider Details

I. General information

NPI: 1932772415
Provider Name (Legal Business Name): BRIGHTSIDE COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2021
Last Update Date: 07/21/2021
Certification Date: 07/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 W FIELD AVE
HILDALE UT
84784-7798
US

IV. Provider business mailing address

943 N 100 W
HURRICANE UT
84737-1676
US

V. Phone/Fax

Practice location:
  • Phone: 435-767-7957
  • Fax:
Mailing address:
  • Phone: 435-767-7957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: PHILLIP ALLEN CANDLAND
Title or Position: LMFT/OWNER
Credential: LMFT
Phone: 435-767-7957