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General NPI Number Information
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NPI Number | 1386578482
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Entity Type | Organization
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Legal Business Name | JUNIPER GROVE COUNSELING, PLLC
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Dates
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Enumeration Date | 06/11/2026
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Last Update Date | 06/11/2026
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Provider Practice Location Address
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Address Line | 831 E 340 S STE 210
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City | AMERICAN FORK
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State | UT
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Zip | 84003-3329
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Country | US
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Telephone | 385-265-2680
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Fax |
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Provider Business Mailing Address
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Address Line | 831 E 340 S STE 210
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City | AMERICAN FORK
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State | UT
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Zip | 84003-3329
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Country | US
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Telephone | 385-265-2680
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Fax |
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Authorized Official
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Title or Position | OWNER, THERAPIST
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Name | ALYSSA BLACK
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Credential | LCSW
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Telephone | 801-635-9704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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