| True Self Revival Counseling, Llc | |
|
639 E 1375 S Vernal UT 84078-1270 | |
| (435) 210-0997 | |
| Not Available |
| Full Name | True Self Revival Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 639 E 1375 S, Vernal, Utah |
| Authorized Official Name and Position | Diana Carney (CEO) |
| Authorized Official Contact | 4352100997 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| True Self Revival Counseling, Llc 639 E 1375 S Vernal UT 84078-1270 Ph: (435) 210-0997 | True Self Revival Counseling, Llc 639 E 1375 S Vernal UT 84078-1270 Ph: (435) 210-0997 |
| NPI Number | 1255112918 |
|---|---|
| Provider Enumeration Date | 10/09/2023 |
| Last Update Date | 10/09/2023 |
| Certification Date | 10/09/2023 |
| Medicare PECOS PAC ID | 2961855101 |
|---|---|
| Medicare Enrollment ID | O20240124002640 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255112918 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Diana Carney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962854190 PECOS PAC ID: 7416343116 Enrollment ID: I20220406000484 |
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