Healthcare Provider Details

I. General information

NPI: 1780353755
Provider Name (Legal Business Name): COVE COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2021
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3549 N UNIVERSITY AVE STE 325
PROVO UT
84604-6693
US

IV. Provider business mailing address

3549 N UNIVERSITY AVE STE 325
PROVO UT
84604-6693
US

V. Phone/Fax

Practice location:
  • Phone: 801-609-8421
  • Fax:
Mailing address:
  • Phone: 801-609-8421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
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: ALEXANDER JOHNSON
Title or Position: OWNER
Credential: LCSW
Phone: 801-609-8421