Healthcare Provider Details

I. General information

NPI: 1467080507
Provider Name (Legal Business Name): WHITE CANVAS COUNSELLING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 04/01/2020
Certification Date: 04/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 S STATE ST STE E1-C
OREM UT
84058-6354
US

IV. Provider business mailing address

212 E CROSSROADS BLVD # 107
SARATOGA SPRINGS UT
84045-2966
US

V. Phone/Fax

Practice location:
  • Phone: 435-820-0135
  • Fax:
Mailing address:
  • Phone: 435-820-0135
  • 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: MR. CHRISTOPHER J. SCOTT
Title or Position: OWNER
Credential: CMHC
Phone: 435-820-0135