Healthcare Provider Details

I. General information

NPI: 1497126858
Provider Name (Legal Business Name): CHAT & CHANGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2015
Last Update Date: 10/21/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 E 4800 S STE 220
MURRAY UT
84107-5533
US

IV. Provider business mailing address

1212 OAKRIDGE DR P.O. BOX 301
CENTERVILLE UT
84014-1540
US

V. Phone/Fax

Practice location:
  • Phone: 385-368-8229
  • Fax: 801-747-6858
Mailing address:
  • Phone: 801-657-1581
  • Fax: 801-747-6858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. FRANK DAVID ELDER
Title or Position: MANAGER
Credential: LCSW
Phone: 385-368-8228