Healthcare Provider Details

I. General information

NPI: 1891266227
Provider Name (Legal Business Name): DISCOVERY FAMILY COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2018
Last Update Date: 12/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

244 W 520 N
OREM UT
84057-4695
US

IV. Provider business mailing address

244 W 520 N
OREM UT
84057-4695
US

V. Phone/Fax

Practice location:
  • Phone: 801-636-7074
  • Fax: 801-406-0089
Mailing address:
  • Phone: 801-636-7074
  • Fax: 801-406-0089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BARBARA BRONSON
Title or Position: CLINICAL DIRECTOR/OWNER
Credential: LCSW
Phone: 801-636-7074