Healthcare Provider Details

I. General information

NPI: 1063989788
Provider Name (Legal Business Name): PERFECT BALANCE COUNSELING & CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2018
Last Update Date: 10/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1169 S 600 E
PAYSON UT
84651-4561
US

IV. Provider business mailing address

1169 S 600 E
PAYSON UT
84651-4561
US

V. Phone/Fax

Practice location:
  • Phone: 801-864-0801
  • Fax:
Mailing address:
  • Phone: 801-864-0801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. ALLISON HANSEN
Title or Position: CLINICAL MENTAL HEALTH COUNSELOR/AD
Credential: CMHC
Phone: 385-250-9255