Provider Demographics
NPI:1184133571
Name:CONNECTED LIFE COUNSELING CENTER, LLC
Entity type:Organization
Organization Name:CONNECTED LIFE COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULER
Authorized Official - Suffix:
Authorized Official - Credentials:CMHC
Authorized Official - Phone:801-903-1276
Mailing Address - Street 1:8835 S PINION LN
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-9264
Mailing Address - Country:US
Mailing Address - Phone:801-694-9306
Mailing Address - Fax:
Practice Address - Street 1:741 E 9000 S STE 200D
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-3085
Practice Address - Country:US
Practice Address - Phone:801-903-1276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-28
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health