Healthcare Provider Details

I. General information

NPI: 1285447433
Provider Name (Legal Business Name): ORA COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 GOLF COURSE RD STE A
LOGAN UT
84321-5951
US

IV. Provider business mailing address

115 GOLF COURSE RD STE A
LOGAN UT
84321-5951
US

V. Phone/Fax

Practice location:
  • Phone: 435-279-6036
  • Fax:
Mailing address:
  • Phone: 435-279-6036
  • 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 StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateNULL

VIII. Authorized Official

Name: TRICIA HANCOCK
Title or Position: OFFICE MANAGER
Credential:
Phone: 435-279-6036