Healthcare Provider Details

I. General information

NPI: 1447227731
Provider Name (Legal Business Name): ASPEN GROVE COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 FOOTHILL DR SUITE 24
SALT LAKE CITY UT
84108-2327
US

IV. Provider business mailing address

1400 FOOTHILL DR SUITE 24
SALT LAKE CITY UT
84108-2327
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-0422
  • Fax: 801-581-0764
Mailing address:
  • Phone: 801-581-0422
  • Fax: 801-581-0764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number49222542501
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3763253501
License Number StateUT

VIII. Authorized Official

Name: DR. MARK K. BURTON
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 801-581-0422