Provider Demographics
NPI:1295092674
Name:TRI ASPEN COUNSELING LLC
Entity type:Organization
Organization Name:TRI ASPEN COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:TRINITY
Authorized Official - Middle Name:L
Authorized Official - Last Name:VERCIMAK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-419-1269
Mailing Address - Street 1:812 ASHTON AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84106-1804
Mailing Address - Country:US
Mailing Address - Phone:801-419-1269
Mailing Address - Fax:
Practice Address - Street 1:11487 S 700 E
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-9067
Practice Address - Country:US
Practice Address - Phone:801-419-1269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT701394-3501251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health