Healthcare Provider Details

I. General information

NPI: 1093255226
Provider Name (Legal Business Name): COUNSELING MADE SIMPLE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2017
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

665 N 1890 W STE 47A
PROVO UT
84601-1326
US

IV. Provider business mailing address

665 N 1890 W STE 47A
PROVO UT
84601-1326
US

V. Phone/Fax

Practice location:
  • Phone: 385-626-9345
  • Fax:
Mailing address:
  • Phone: 385-626-9345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number320724-3501
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: LINDA MARIE TAYLOR
Title or Position: CLINICAL DIRECTOR
Credential: LCSW
Phone: 385-626-9345