Provider Demographics
NPI:1265997746
Name:SUMMIT COUNSELING SOLUTIONS
Entity type:Organization
Organization Name:SUMMIT COUNSELING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ERICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:CMHC
Authorized Official - Phone:801-678-4198
Mailing Address - Street 1:4838 W PILLAR DR
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84096-1428
Mailing Address - Country:US
Mailing Address - Phone:801-678-4198
Mailing Address - Fax:
Practice Address - Street 1:4838 W PILLAR DR
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84096-1428
Practice Address - Country:US
Practice Address - Phone:801-678-4198
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health