Provider Demographics
NPI:1467080507
Name:WHITE CANVAS COUNSELLING LLC
Entity Type:Organization
Organization Name:WHITE CANVAS COUNSELLING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:CMHC
Authorized Official - Phone:435-820-0135
Mailing Address - Street 1:212 E CROSSROADS BLVD # 107
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:UT
Mailing Address - Zip Code:84045-2966
Mailing Address - Country:US
Mailing Address - Phone:435-820-0135
Mailing Address - Fax:
Practice Address - Street 1:560 S STATE ST STE E1-C
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-6354
Practice Address - Country:US
Practice Address - Phone:435-820-0135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-01
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty