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NPI Code Detail

MEDICARE: NOVA COUNSELING LLC

MEDICARE: NOVA COUNSELING 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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1376369702
Entity Type Code : Organization
Provider Name (Legal Business Name) : NOVA COUNSELING LLC
Provider Business Mailing Address
First Line : 3311 N UNIVERSITY AVE STE 200
Second Line :
City : PROVO
State : UT
Zip : 84604-7421
Country : US
Telephone Number : 801-900-4802
Fax Number :
Provider Business Practice Location Address
First Line : 3311 N UNIVERSITY AVE STE 200
Second Line :
City : PROVO
State : UT
Zip : 84604-7421
Country : US
Telephone Number : 801-900-4802
Fax Number :
Authorized Official
Title or Position : OWNER
Name : HELI WHITE
Credential : LCSW
Telephone Number : 801-360-6890
Provider Enumeration Date : 12/02/2024
Last Update Date : 12/02/2024

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Directions to “NOVA COUNSELING LLC ” Practice Location

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