Healthcare Provider Details

I. General information

NPI: 1386504835
Provider Name (Legal Business Name): FREE FLOW PSYCHOTHERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2025
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5784 S 900 E # 14
MURRAY UT
84121-1689
US

IV. Provider business mailing address

5784 S 900 E # 14
MURRAY UT
84121-1689
US

V. Phone/Fax

Practice location:
  • Phone: 385-355-1295
  • Fax:
Mailing address:
  • Phone: 385-355-1295
  • 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: MRS. BROOK MINGO
Title or Position: OWNER
Credential: CMHC
Phone: 385-355-1295