Provider Demographics
NPI:1336452481
Name:LIFEMATTERS COUNSELING & HEALTH CENTER
Entity Type:Organization
Organization Name:LIFEMATTERS COUNSELING & HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:BUTTERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:801-313-0555
Mailing Address - Street 1:740 E 3900 S
Mailing Address - Street 2:#100
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-2181
Mailing Address - Country:US
Mailing Address - Phone:801-313-0555
Mailing Address - Fax:801-313-9669
Practice Address - Street 1:740 E 3900 S
Practice Address - Street 2:#100
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-2181
Practice Address - Country:US
Practice Address - Phone:801-313-0555
Practice Address - Fax:801-313-9669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4739460-35011041C0700X
UT200147-8900363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty