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General NPI Number Information
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NPI Number | 1497126858
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Entity Type | Organization
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Legal Business Name | CHAT & CHANGE
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Dates
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Enumeration Date | 10/12/2015
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 835 E 4800 S STE 220
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City | MURRAY
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State | UT
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Zip | 84107-5533
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Country | US
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Telephone | 385-368-8229
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Fax | 801-747-6858
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Provider Business Mailing Address
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Address Line | 1212 OAKRIDGE DR P.O. BOX 301
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City | CENTERVILLE
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State | UT
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Zip | 84014-1540
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Country | US
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Telephone | 801-657-1581
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Fax | 801-747-6858
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Authorized Official
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Title or Position | MANAGER
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Name | MR. FRANK DAVID ELDER
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Credential | LCSW
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Telephone | 385-368-8228
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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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Taxonomy #2
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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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