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General NPI Number Information
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NPI Number | 1265041842
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Entity Type | Organization
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Legal Business Name | MOUNTAIN VALLEY COUNSELING, LLC
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Dates
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Enumeration Date | 07/29/2020
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Last Update Date | 07/29/2020
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Provider Practice Location Address
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Address Line | 10393 S TEMPLE DR STE 103
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-8883
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Country | US
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Telephone | 801-236-3892
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Fax |
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Provider Business Mailing Address
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Address Line | 10393 S TEMPLE DR STE 103
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-8883
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Country | US
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Telephone | 801-236-3892
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL MENTAL HEALTH COUNSE
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Name | MISTY JUNE NEWMAN
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Credential | CMHC
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Telephone | 801-236-3892
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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 |
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