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General NPI Number Information
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NPI Number | 1811505357
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Entity Type | Organization
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Legal Business Name | KAREN COULAM, MSW, LCSW, COUNSELING SERVICES
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Dates
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Enumeration Date | 07/21/2020
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Last Update Date | 07/21/2020
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Provider Practice Location Address
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Address Line | 96 N 500 W
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City | BOUNTIFUL
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State | UT
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Zip | 84010-7078
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Country | US
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Telephone | 801-692-7292
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Fax |
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Provider Business Mailing Address
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Address Line | 460 N 1250 E
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City | BOUNTIFUL
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State | UT
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Zip | 84010-2700
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Country | US
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Telephone | 801-663-2195
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Fax |
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Authorized Official
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Title or Position | CO OWNER/THERAPIST
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Name | KAREN C COULAM
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Credential | LCSW
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Telephone | 801-663-2195
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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 |
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License Number State |
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