Provider Demographics
NPI:1124181136
Name:SUMMIT COUNSELING SERVICES, INC
Entity Type:Organization
Organization Name:SUMMIT COUNSELING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:HINDS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:435-752-4646
Mailing Address - Street 1:95 W 100 S
Mailing Address - Street 2:SUITE 130
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84321-5810
Mailing Address - Country:US
Mailing Address - Phone:435-752-4646
Mailing Address - Fax:435-755-0579
Practice Address - Street 1:95 W 100 S
Practice Address - Street 2:SUITE 130
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84321-5810
Practice Address - Country:US
Practice Address - Phone:435-752-4646
Practice Address - Fax:435-755-0579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT48456193902251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health