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General NPI Number Information
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NPI Number | 1023922630
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Entity Type | Organization
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Legal Business Name | CHANGING LIVES COUNSELING ALLEN MENTAL HEALTH
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Dates
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Enumeration Date | 09/30/2026
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Last Update Date | 09/30/2026
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Provider Practice Location Address
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Address Line | 9055 S 1300 E
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City | SANDY
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State | UT
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Zip | 84094-3133
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Country | US
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Telephone | 801-332-9838
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Fax |
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Provider Business Mailing Address
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Address Line | 1213 W SADDLE BLUFF DR
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City | MURRAY
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State | UT
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Zip | 84123-2912
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Country | US
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Telephone | 505-463-5598
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | TIMOTHY WITH ALLEN
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Credential | CMHC
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Telephone | 801-332-9838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | NULL
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