Healthcare Provider Details

I. General information

NPI: 1669249751
Provider Name (Legal Business Name): HEALING PAINS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2023
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 W LINDEN LN
MAPLETON UT
84664-5159
US

IV. Provider business mailing address

152 W LINDEN LN
MAPLETON UT
84664-5159
US

V. Phone/Fax

Practice location:
  • Phone: 801-477-6257
  • Fax:
Mailing address:
  • Phone: 801-477-6257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JACOB GRANT BROWN
Title or Position: OWNER/THERAPIST
Credential: CMHC
Phone: 801-477-6257