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General NPI Number Information
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NPI Number | 1275140089
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Entity Type | Organization
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Legal Business Name | LOVE & WELLNESS COUNSELING
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Dates
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Enumeration Date | 09/25/2020
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Last Update Date | 04/10/2026
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Provider Practice Location Address
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Address Line | 628 N PUGSLEY ST
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City | SALT LAKE CITY
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State | UT
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Zip | 84103-1329
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Country | US
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Telephone | 385-261-2171
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Fax | 385-261-2827
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Provider Business Mailing Address
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Address Line | 628 N PUGSLEY ST
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City | SALT LAKE CITY
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State | UT
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Zip | 84103-1329
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Country | US
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Telephone | 385-261-2171
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Fax | 385-261-2827
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Authorized Official
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Title or Position | MENTAL HEALTH COUNSELOR
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Name | MS. SANDRA CHACON
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Credential | LCSW
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Telephone | 801-991-0484
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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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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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