Provider Demographics
NPI:1891275020
Name:BOE EBY CMHC, LLC
Entity Type:Organization
Organization Name:BOE EBY CMHC, LLC
Other - Org Name:UNITED COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:BOE
Authorized Official - Middle Name:
Authorized Official - Last Name:EBY
Authorized Official - Suffix:
Authorized Official - Credentials:CMHC
Authorized Official - Phone:801-913-5346
Mailing Address - Street 1:7244 W FLAXTON LN
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84081-5759
Mailing Address - Country:US
Mailing Address - Phone:801-913-5346
Mailing Address - Fax:
Practice Address - Street 1:7105 S HIGHLAND DR STE 200
Practice Address - Street 2:
Practice Address - City:COTTONWOOD HEIGHTS
Practice Address - State:UT
Practice Address - Zip Code:84121-7311
Practice Address - Country:US
Practice Address - Phone:801-913-5346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-16
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5069670-6004261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)