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NPI Code Detail

MEDICARE: CENTRAL UTAH COUNSELING CENTER

MEDICARE: CENTRAL UTAH COUNSELING CENTER
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YM0800XMental Health Counselor
3101Y00000XCounselor

General Provider Information

NPI Number : 1639185424
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTRAL UTAH COUNSELING CENTER
Provider Business Mailing Address
First Line : 152 N 400 W
Second Line :
City : EPHRAIM
State : UT
Zip : 84627-5549
Country : US
Telephone Number : 435-283-8400
Fax Number : 435-283-8401
Provider Business Practice Location Address
First Line : 152 N 400 W
Second Line :
City : EPHRAIM
State : UT
Zip : 84627-5549
Country : US
Telephone Number : 435-283-8400
Fax Number :
Authorized Official
Title or Position : CFO
Name : RICHARD ANDERSON
Credential :
Telephone Number : 435-283-8400
Provider Enumeration Date : 07/31/2006
Last Update Date : 03/24/2026

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1225255235 — DANE THURSTON PA
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1033447412 — JARED LYNN KUMMER
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1730486887 — MS. RALAINA M TAYLOR
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84627-5549
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Directions to “CENTRAL UTAH COUNSELING CENTER ” Practice Location

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