MEDICARE: ELOWEN COUNSELING PLLC

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	:	1942144894
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELOWEN COUNSELING PLLC

Provider Business Mailing Address
First Line	:	560 BRENTWOOD CIR
Second Line	:
City	:	BOUNTIFUL
State	:	UT
Zip	:	84010-4926
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	925 E EXECUTIVE PARK DR STE B
Second Line	:
City	:	MURRAY
State	:	UT
Zip	:	84117-3545
Country	:	US
Telephone Number	:	801-923-3497
Fax Number	:

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	KAITLIN LONGFELLOW
Credential	:	CMHC
Telephone Number	:	801-923-3497

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	04/20/2026

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