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General NPI Number Information
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NPI Number | 1053263046
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Entity Type | Organization
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Legal Business Name | HOLDING SPACE COUNSELING PLLC
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Dates
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Enumeration Date | 02/11/2026
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 1576 S 500 W
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City | WOODS CROSS
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State | UT
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Zip | 84010-7433
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Country | US
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Telephone | 801-209-1212
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Fax |
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Provider Business Mailing Address
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Address Line | 5398 S 1345 W
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City | RIVERDALE
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State | UT
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Zip | 84405-4000
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Country | US
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Telephone | 801-209-1212
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Fax |
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Authorized Official
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Title or Position | CLINICAL MENTAL HEALTH COUNSELOR
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Name | JESSICA BLACK
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Credential | CMHC
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Telephone | 801-209-1212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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