Provider Demographics
NPI:1659986917
Name:ALLIANCE COUNSELING PLLC
Entity Type:Organization
Organization Name:ALLIANCE COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:ALLISON
Authorized Official - Last Name:MIDYETT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-403-6470
Mailing Address - Street 1:352 S DENVER ST # 215
Mailing Address - Street 2:
Mailing Address - City:SLC
Mailing Address - State:UT
Mailing Address - Zip Code:84111-3000
Mailing Address - Country:US
Mailing Address - Phone:801-403-6470
Mailing Address - Fax:801-515-4704
Practice Address - Street 1:352 S DENVER ST # 215
Practice Address - Street 2:
Practice Address - City:SLC
Practice Address - State:UT
Practice Address - Zip Code:84111-3000
Practice Address - Country:US
Practice Address - Phone:801-403-6470
Practice Address - Fax:801-515-4704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty