Provider Demographics
NPI:1629834353
Name:HEALING HOUSE THERAPY AND WELLNESS
Entity Type:Organization
Organization Name:HEALING HOUSE THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST, CO-FOUNDER, SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KNUTH
Authorized Official - Suffix:
Authorized Official - Credentials:CMHC
Authorized Official - Phone:801-499-4244
Mailing Address - Street 1:3556 S 5600 W STE 1
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84120-2815
Mailing Address - Country:US
Mailing Address - Phone:801-477-0127
Mailing Address - Fax:
Practice Address - Street 1:2325 E TREASURE MOUNTAIN CIR
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84093-1749
Practice Address - Country:US
Practice Address - Phone:881-477-0127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty