Healthcare Provider Details

I. General information

NPI: 1194662759
Provider Name (Legal Business Name): HARBOR LIGHT THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

549 25TH ST STE 206
OGDEN UT
84401-2491
US

IV. Provider business mailing address

549 25TH ST STE 206
OGDEN UT
84401-2491
US

V. Phone/Fax

Practice location:
  • Phone: 801-410-0373
  • Fax: 801-779-7808
Mailing address:
  • Phone: 801-410-0373
  • Fax: 801-779-7808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: KAMIE BARNES
Title or Position: LCSW
Credential:
Phone: 801-410-0373