Healthcare Provider Details
I. General information
NPI: 1235074642
Provider Name (Legal Business Name): ALPENGLOW COUNSELING AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2602 N WASHINGTON BLVD STE B
NORTH OGDEN UT
84414-2243
US
IV. Provider business mailing address
3381 N 675 E
NORTH OGDEN UT
84414-1692
US
V. Phone/Fax
- Phone: 801-317-8524
- Fax:
- Phone: 810-869-3874
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
GINA
NICOLE
SHUSTER
Title or Position: OWNER AND CLINICAL DIRECTOR
Credential: LCSW, LMSW
Phone: 801-317-8524