| Tooele Valley Counseling Pllc | |
|
1244 N Main St Ste 202 Tooele UT 84074-5009 | |
| (435) 850-7378 | |
| (435) 200-4364 |
| Full Name | Tooele Valley Counseling Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1244 N Main St Ste 202, Tooele, Utah |
| Authorized Official Name and Position | Darci D Alston (SOLE OWNER) |
| Authorized Official Contact | 4358507378 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tooele Valley Counseling Pllc 28 N Main St Ste 1 Tooele UT 84074-2139 Ph: (435) 850-7378 | Tooele Valley Counseling Pllc 1244 N Main St Ste 202 Tooele UT 84074-5009 Ph: (435) 850-7378 |
| NPI Number | 1275136228 |
|---|---|
| Provider Enumeration Date | 11/20/2020 |
| Last Update Date | 04/24/2024 |
| Certification Date | 04/24/2024 |
| Medicare PECOS PAC ID | 5496299380 |
|---|---|
| Medicare Enrollment ID | O20240702003726 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275136228 | NPI | - | NPPES |
| 1134559388 | Medicaid | UT | |
| 1629357132 | Medicaid | NY | |
| 1295027001 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Guy Patrick Exon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063796381 PECOS PAC ID: 4587024518 Enrollment ID: I20230721001414 |
| Provider Name | Darci Denney Alston |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629357132 PECOS PAC ID: 6305380296 Enrollment ID: I20240702003880 |
| Provider Name | Breanne Westwood |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295027001 PECOS PAC ID: 2860938727 Enrollment ID: I20240726003443 |
| Provider Name | Raquel M Rhoads |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104391408 PECOS PAC ID: 6406394931 Enrollment ID: I20240815001974 |
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