Provider Demographics
NPI:1346845716
Name:NEIGHBORHOOD COUNSELING
Entity Type:Organization
Organization Name:NEIGHBORHOOD COUNSELING
Other - Org Name:MINDSET FAMILY THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNABELLA
Authorized Official - Middle Name:Z
Authorized Official - Last Name:HAGEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-739-0480
Mailing Address - Street 1:1699 N 1820 W
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-7201
Mailing Address - Country:US
Mailing Address - Phone:801-739-0480
Mailing Address - Fax:
Practice Address - Street 1:3355 N UNIVERSITY AVE STE 100
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-6618
Practice Address - Country:US
Practice Address - Phone:801-427-1054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-02
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty