Healthcare Provider Details

I. General information

NPI: 1780449967
Provider Name (Legal Business Name): ECLIPSE COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2024
Last Update Date: 02/16/2024
Certification Date: 02/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

352 N MAIN ST
TOOELE UT
84074-1657
US

IV. Provider business mailing address

772 N MAIN ST # 214
TOOELE UT
84074-1612
US

V. Phone/Fax

Practice location:
  • Phone: 385-519-4737
  • Fax:
Mailing address:
  • Phone: 385-519-4737
  • 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: NATALIE DAY
Title or Position: OWNER/CLINICAL THERAPIST
Credential: LCSW
Phone: 385-519-4737