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General NPI Number Information
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NPI Number | 1770025918
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Entity Type | Organization
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Legal Business Name | REACH COUNSELING, LLC
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Dates
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Enumeration Date | 11/04/2016
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Last Update Date | 11/04/2016
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Provider Practice Location Address
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Address Line | 885 W BAXTER DR
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-8506
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Country | US
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Telephone | 801-971-5187
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Fax |
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Provider Business Mailing Address
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Address Line | 885 W BAXTER DR
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-8506
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LCSW/OWNER
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Name | ASHLEY HENDERSON
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Credential |
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Telephone | 801-971-5187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 7089768-3501
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License Number State | UT
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