Provider Demographics
NPI:1760971006
Name:WORDS OF WISDOM COUNSELING
Entity Type:Organization
Organization Name:WORDS OF WISDOM COUNSELING
Other - Org Name:SAFE SPACE COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:VAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:CMHC, LMFT
Authorized Official - Phone:850-774-1574
Mailing Address - Street 1:4076 E SOUTH PASS RD
Mailing Address - Street 2:
Mailing Address - City:EAGLE MOUNTAIN
Mailing Address - State:UT
Mailing Address - Zip Code:84005-6049
Mailing Address - Country:US
Mailing Address - Phone:801-341-9521
Mailing Address - Fax:
Practice Address - Street 1:379 N UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84601-2854
Practice Address - Country:US
Practice Address - Phone:801-341-9521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-02
Last Update Date:2024-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FLMH15040101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty