Provider Demographics
NPI:1891266227
Name:DISCOVERY FAMILY COUNSELING
Entity Type:Organization
Organization Name:DISCOVERY FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRONSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-636-7074
Mailing Address - Street 1:244 W 520 N
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-4695
Mailing Address - Country:US
Mailing Address - Phone:801-636-7074
Mailing Address - Fax:801-406-0089
Practice Address - Street 1:244 W 520 N
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-4695
Practice Address - Country:US
Practice Address - Phone:801-636-7074
Practice Address - Fax:801-406-0089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-11
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT013055721OtherDRIVERS LISCENCE