MEDICARE: K2 COUNSELING & CONSULTING

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12113466	OTHER		CAQH

General Provider Information

NPI Number	:	1124682018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	K2 COUNSELING & CONSULTING

Provider Business Mailing Address
First Line	:	498 N 900 W STE 200
Second Line	:
City	:	KAYSVILLE
State	:	UT
Zip	:	84037-4153
Country	:	US
Telephone Number	:	801-525-4645
Fax Number	:	801-779-7808

Provider Business Practice Location Address
First Line	:	2363 N HILL FIELD RD STE 5
Second Line	:
City	:	LAYTON
State	:	UT
Zip	:	84041-6910
Country	:	US
Telephone Number	:	801-525-4645
Fax Number	:	801-779-7808

Authorized Official
Title or Position	:	OWNER, THERAPIST
Name	:	KARSON KINIKINI
Credential	:	CMHC
Telephone Number	:	801-628-3092

Provider Enumeration Date	:	04/25/2019
Last Update Date	:	10/31/2022

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