Healthcare Provider Details

I. General information

NPI: 1770488769
Provider Name (Legal Business Name): PATH & PRESENCE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 OLD STONE HOUSE WAY
PARK CITY UT
84098-5413
US

IV. Provider business mailing address

1021 OLD STONE HOUSE WAY
PARK CITY UT
84098-5413
US

V. Phone/Fax

Practice location:
  • Phone: 435-776-5606
  • Fax:
Mailing address:
  • Phone: 435-776-5606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: CARINA NATION
Title or Position: OWNER/FOUNDER
Credential: CMHC
Phone: 435-776-5606