MEDICARE: TREEVIEW STREET COUNSELING SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1073168456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TREEVIEW STREET COUNSELING SERVICES, LLC

Provider Business Mailing Address
First Line	:	PO BOX 1015
Second Line	:
City	:	WEST JORDAN
State	:	UT
Zip	:	84084-7015
Country	:	US
Telephone Number	:	801-889-8291
Fax Number	:	385-202-0254

Provider Business Practice Location Address
First Line	:	1365 W GREEN HEDGE WAY
Second Line	:
City	:	WEST JORDAN
State	:	UT
Zip	:	84084-4139
Country	:	US
Telephone Number	:	801-889-8291
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DAVID DONLEE ALLRED
Credential	:	DMFT, LMFT
Telephone Number	:	801-889-8291

Provider Enumeration Date	:	08/02/2019
Last Update Date	:	11/30/2020

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