Provider Demographics
NPI:1457725764
Name:HOPE AND HEALING CHILD AND FAMILY COUNSELING
Entity Type:Organization
Organization Name:HOPE AND HEALING CHILD AND FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:801-893-2221
Mailing Address - Street 1:11233 S WOODFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-2209
Mailing Address - Country:US
Mailing Address - Phone:801-893-2221
Mailing Address - Fax:801-983-6290
Practice Address - Street 1:11075 S STATE ST STE 30
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-5129
Practice Address - Country:US
Practice Address - Phone:801-893-2221
Practice Address - Fax:801-983-6290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-24
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health