Healthcare Provider Details

I. General information

NPI: 1720905003
Provider Name (Legal Business Name): UTAH MENTAL HEALTH ADVOCATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 S LUNAR WAY
MAPLETON UT
84664-3143
US

IV. Provider business mailing address

54 S LUNAR WAY
MAPLETON UT
84664-3143
US

V. Phone/Fax

Practice location:
  • Phone: 509-981-9424
  • Fax:
Mailing address:
  • Phone: 509-981-9424
  • 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: JOSEPH HOLLENBAUGH
Title or Position: OWNER
Credential:
Phone: 509-981-9424