Provider Demographics
NPI:1205314747
Name:NORTH STAR COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:NORTH STAR COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:ROCKWELL
Authorized Official - Last Name:CLAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-317-3809
Mailing Address - Street 1:481 E 1950 N
Mailing Address - Street 2:
Mailing Address - City:NORTH OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84414-3015
Mailing Address - Country:US
Mailing Address - Phone:801-317-3809
Mailing Address - Fax:
Practice Address - Street 1:298 24TH ST STE 204
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-1870
Practice Address - Country:US
Practice Address - Phone:801-317-3809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-06
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0850X
UT6720347-3501261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT18173560Medicaid