Healthcare Provider Details
I. General information
NPI: 1295661056
Provider Name (Legal Business Name): REFORGE COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6975 S UNION PARK CTR STE 614
MIDVALE UT
84047-6501
US
IV. Provider business mailing address
PO BOX 26
CENTERVILLE UT
84014-0026
US
V. Phone/Fax
- Phone: 385-276-2256
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTIAN
OWNSBEY
Title or Position: OWNER
Credential:
Phone: 801-550-8657