Provider Demographics
NPI:1891225249
Name:HERRIMAN COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:HERRIMAN COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MADSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-520-5724
Mailing Address - Street 1:5627 W 13100 S STE B
Mailing Address - Street 2:
Mailing Address - City:HERRIMAN
Mailing Address - State:UT
Mailing Address - Zip Code:84096-6921
Mailing Address - Country:US
Mailing Address - Phone:801-217-9600
Mailing Address - Fax:801-303-9210
Practice Address - Street 1:5627 W 13100 S STE B
Practice Address - Street 2:
Practice Address - City:HERRIMAN
Practice Address - State:UT
Practice Address - Zip Code:84096-6921
Practice Address - Country:US
Practice Address - Phone:801-217-9600
Practice Address - Fax:801-303-9210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-19
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8003723-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty