Provider Demographics
NPI:1902232085
Name:SUNCREST COUNSELING
Entity Type:Organization
Organization Name:SUNCREST COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:JUDD
Authorized Official - Suffix:
Authorized Official - Credentials:ACMHC
Authorized Official - Phone:801-255-1155
Mailing Address - Street 1:1258 WEST SOUTH JORDAN PARKWAY, STE. 202
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095
Mailing Address - Country:US
Mailing Address - Phone:801-255-1155
Mailing Address - Fax:
Practice Address - Street 1:1258 WEST SOUTH JORDAN PARKWAY, STE. 202
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095
Practice Address - Country:US
Practice Address - Phone:801-255-1155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT86001116009251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health