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General NPI Number Information
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NPI Number | 1356206999
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Entity Type | Organization
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Legal Business Name | MINDSCAPE COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 940 N 400 E STE 101 STE 101
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City | NORTH SALT LAKE
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State | UT
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Zip | 84054-1984
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Country | US
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Telephone | 385-402-3396
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 540611
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City | NORTH SALT LAKE
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State | UT
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Zip | 84054-0611
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Country | US
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Telephone | 385-402-3396
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EMILY VANESSA ROSE
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Credential | LCSW
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Telephone | 801-610-1010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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