Provider Demographics
NPI:1073266946
Name:ATTACHED COUNSELING
Entity Type:Organization
Organization Name:ATTACHED COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:QRYSTEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-855-6462
Mailing Address - Street 1:2287 S WELLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84106-4169
Mailing Address - Country:US
Mailing Address - Phone:801-855-6462
Mailing Address - Fax:
Practice Address - Street 1:2287 S WELLINGTON ST
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-4169
Practice Address - Country:US
Practice Address - Phone:801-855-6462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty