Healthcare Provider Details

I. General information

NPI: 1629933643
Provider Name (Legal Business Name): TWO RIDGES OUTPATIENT WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 N STATE ST
MT PLEASANT UT
84647-1108
US

IV. Provider business mailing address

265 N STATE ST
MT PLEASANT UT
84647-1108
US

V. Phone/Fax

Practice location:
  • Phone: 801-633-4683
  • Fax: 435-271-3035
Mailing address:
  • Phone: 208-440-6382
  • Fax: 435-271-3035

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: NATALEE SORENSEN
Title or Position: OWNER
Credential:
Phone: 801-633-4683