Healthcare Provider Details

I. General information

NPI: 1932962917
Provider Name (Legal Business Name): ASCENT HEALING COUNSELING SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2024
Last Update Date: 02/05/2024
Certification Date: 02/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 S FAIRFIELD RD STE A120
LAYTON UT
84041-7105
US

IV. Provider business mailing address

124 S FAIRFIELD RD STE A120
LAYTON UT
84041-7105
US

V. Phone/Fax

Practice location:
  • Phone: 801-773-7060
  • Fax:
Mailing address:
  • Phone: 801-773-7060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: JAMILLE JOHNSON
Title or Position: OWNER
Credential:
Phone: 801-603-9671