| Kintsugi Counseling, Llc | |
|
150 N Main St Ste 204 Heber City UT 84032-1671 | |
| (435) 850-7402 | |
| (435) 538-7000 |
| Full Name | Kintsugi Counseling, Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 150 N Main St Ste 204, Heber City, Utah |
| Authorized Official Name and Position | Jacqueline Evans-mcalister (MENTAL HEALTH THERAPIST) |
| Authorized Official Contact | 4358507402 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kintsugi Counseling, Llc 520 N Main Street Suite C#448 Heber City UT 84032 Ph: (435) 850-7402 | Kintsugi Counseling, Llc 150 N Main St Ste 204 Heber City UT 84032-1671 Ph: (435) 850-7402 |
| NPI Number | 1013478346 |
|---|---|
| Provider Enumeration Date | 03/28/2019 |
| Last Update Date | 04/22/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013478346 | NPI | - | NPPES |
| 9056683-6004 | Other | UT | STATE LICENSE FOR PRACTICE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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