Healthcare Provider Details
I. General information
NPI: 1558278564
Provider Name (Legal Business Name): AZUL CONSULTING AND COUNSELING GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
522 E 100 S
SLC UT
84102-2090
US
IV. Provider business mailing address
522 E 100 S
SLC UT
84102-2090
US
V. Phone/Fax
- Phone: 801-529-3308
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JENNIFER
HEBDON-SELJESTAD
Title or Position: OWNER
Credential: LCSW
Phone: 801-529-3308