| Momentum Counseling Services, Corp | |
|
11075 S State St Ste 13 Sandy UT 84070-5193 | |
| (801) 948-0939 | |
| Not Available |
| Full Name | Momentum Counseling Services, Corp |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 11075 S State St Ste 13, Sandy, Utah |
| Authorized Official Name and Position | Tyler Stark (OWNER) |
| Authorized Official Contact | 8015189362 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Momentum Counseling Services, Corp 1446 E Anvil Dr Draper UT 84020-8832 Ph: (801) 898-7502 | Momentum Counseling Services, Corp 11075 S State St Ste 13 Sandy UT 84070-5193 Ph: (801) 948-0939 |
| NPI Number | 1245729417 |
|---|---|
| Provider Enumeration Date | 05/03/2018 |
| Last Update Date | 05/03/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245729417 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 8598755-6004 (Utah) | Primary |
| 106H00000X | Marriage & Family Therapist | 6153954-3902 (Utah) | Secondary |
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