Provider Demographics
NPI:1518699354
Name:ZEST FOR LIFE COUNSELING - PAYSON
Entity Type:Organization
Organization Name:ZEST FOR LIFE COUNSELING - PAYSON
Other - Org Name:ZEST FOR LIFE COUNSELING - PAYSON
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HYDO
Authorized Official - Suffix:
Authorized Official - Credentials:DSW, LCSW
Authorized Official - Phone:801-980-2566
Mailing Address - Street 1:39 PROFESSIONAL WAY STE 4
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:UT
Mailing Address - Zip Code:84651-1678
Mailing Address - Country:US
Mailing Address - Phone:801-980-2566
Mailing Address - Fax:801-610-2017
Practice Address - Street 1:39 PROFESSIONAL WAY STE 4
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-1678
Practice Address - Country:US
Practice Address - Phone:801-980-2566
Practice Address - Fax:801-610-2017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty