Healthcare Provider Details

I. General information

NPI: 1255752531
Provider Name (Legal Business Name): CHARLES ARTHUR LENAHAN M.A.,LPC, NCC, CSOTS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2014
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 W JONATHON DR
WASHINGTON UT
84780-3126
US

IV. Provider business mailing address

921 W JONATHON DR
WASHINGTON UT
84780-3126
US

V. Phone/Fax

Practice location:
  • Phone: 784-727-3476
  • Fax:
Mailing address:
  • Phone: 678-472-7347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14246479-6004
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC8849
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC009358
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: