Healthcare Provider Details

I. General information

NPI: 1144078320
Provider Name (Legal Business Name): MIND MATTERS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2024
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59 W 9000 S
SANDY UT
84070-2008
US

IV. Provider business mailing address

1230 E PRIVET DR UNIT 4-427
COTTONWOOD HEIGHTS UT
84121-7621
US

V. Phone/Fax

Practice location:
  • Phone: 801-251-6077
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ANDREW ERIC MUNOZ
Title or Position: OWNER
Credential: LCSW
Phone: 801-251-6077