Healthcare Provider Details

I. General information

NPI: 1285241109
Provider Name (Legal Business Name): SUNSET COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2020
Last Update Date: 09/07/2022
Certification Date: 09/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2356 N 400 E STE 203
TOOELE UT
84074-3409
US

IV. Provider business mailing address

2356 N 400 E STE 203
TOOELE UT
84074-3409
US

V. Phone/Fax

Practice location:
  • Phone: 435-850-2547
  • Fax: 435-843-7438
Mailing address:
  • Phone: 435-850-2547
  • Fax: 435-843-7438

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 Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. ESTHER KENISON
Title or Position: OFFICE MANAGER/CLIENTCARECOORDINATO
Credential:
Phone: 435-850-2547