| Lupine Counseling And Psychological Services, Llc | |
|
3051 W Maple Loop Dr Ste 125 Lehi UT 84043-5620 | |
| (801) 616-6926 | |
| Not Available |
| Full Name | Lupine Counseling And Psychological Services, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 3051 W Maple Loop Dr Ste 125, Lehi, Utah |
| Authorized Official Name and Position | Amy Coombs (OWNER) |
| Authorized Official Contact | 8016166926 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lupine Counseling And Psychological Services, Llc 705 E Hidden Manor Cir Lehi UT 84043-4736 Ph: (801) 616-6926 | Lupine Counseling And Psychological Services, Llc 3051 W Maple Loop Dr Ste 125 Lehi UT 84043-5620 Ph: (801) 616-6926 |
| NPI Number | 1578204780 |
|---|---|
| Provider Enumeration Date | 04/05/2022 |
| Last Update Date | 01/15/2023 |
| Certification Date | 01/15/2023 |
| Medicare PECOS PAC ID | 4981081924 |
|---|---|
| Medicare Enrollment ID | O20220513001075 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578204780 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Amy Coombs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699253492 PECOS PAC ID: 1557770542 Enrollment ID: I20210503002807 |
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