MEDICARE: REFLECTIONS COUNSELING AND WELLNESS 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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1104505049
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REFLECTIONS COUNSELING AND WELLNESS LLC

Provider Business Mailing Address
First Line	:	2024 S 1700 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84108-3158
Country	:	US
Telephone Number	:	801-688-2635
Fax Number	:

Provider Business Practice Location Address
First Line	:	2024 S 1700 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84108-3158
Country	:	US
Telephone Number	:	801-688-2635
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	CAMI RAE FUHRIMAN
Credential	:	LCSW
Telephone Number	:	801-688-2635

Provider Enumeration Date	:	07/17/2023
Last Update Date	:	07/17/2023

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