Provider Demographics
NPI:1518685411
Name:RURAL COUNSELING ASSOCIATES LLC
Entity Type:Organization
Organization Name:RURAL COUNSELING ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:LEO
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:435-610-1810
Mailing Address - Street 1:125 NORTH STATE STREET
Mailing Address - Street 2:PO BOX 282
Mailing Address - City:FAIRVIEW
Mailing Address - State:UT
Mailing Address - Zip Code:84629
Mailing Address - Country:US
Mailing Address - Phone:435-610-1810
Mailing Address - Fax:
Practice Address - Street 1:125 N STATE ST
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:UT
Practice Address - Zip Code:84629-5554
Practice Address - Country:US
Practice Address - Phone:435-610-1810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty