Provider Demographics
NPI:1396573440
Name:ZEST FOR LIFE COUNSELING - ST GEORGE
Entity type:Organization
Organization Name:ZEST FOR LIFE COUNSELING - ST GEORGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:HYDO
Authorized Official - Suffix:IV
Authorized Official - Credentials:DSW
Authorized Official - Phone:801-433-8149
Mailing Address - Street 1:556 E 300 S STE 101
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-3844
Mailing Address - Country:US
Mailing Address - Phone:801-980-2566
Mailing Address - Fax:
Practice Address - Street 1:491 E RIVERSIDE DR STE 3A
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7056
Practice Address - Country:US
Practice Address - Phone:801-980-2566
Practice Address - Fax:801-610-2017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty