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General NPI Number Information
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NPI Number | 1750917340
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Entity Type | Organization
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Legal Business Name | WHITE CANVAS COUNSELING
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Dates
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Enumeration Date | 03/16/2020
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Last Update Date | 03/18/2020
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Provider Practice Location Address
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Address Line | 560 S STATE ST
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City | OREM
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State | UT
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Zip | 84058-6354
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Country | US
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Telephone | 435-820-0135
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Fax |
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Provider Business Mailing Address
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Address Line | 212 E CROSSROADS BLVD # 107
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City | SARATOGA SPRINGS
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State | UT
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Zip | 84045-2966
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Country | US
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Telephone | 435-820-0135
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. CHRISTOPHER SCOTT
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Credential | CMHC
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Telephone | 435-820-0135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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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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