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Organization
SEQUOIA COUNSELING SERVICES
Active
Organization
SEQUOIA COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH HENRY TABISH L.C.S.W. (CLINICAL DIRECTOR)
(801) 463-7520
Entity
Organization
Contact information
Practice address
3378 SOUTH 900 EAST, SALT LAKE CITY, UT 84106-2070
(801) 463-7520
(801) 463-7525
Mailing address
3378 SOUTH 900 EAST, SALT LAKE CITY, UT 84106-2070
(801) 463-7520
(801) 463-7525
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
134757
UT
1041C0700X
Clinical Social Worker
13457
UT
1041C0700X
Clinical Social Worker
Primary
18922
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005569802
MEDICARE A
UT
01
—
52836974304001
BLUE CROSS BLUE SHEILD
UT
Enumeration date
03/26/2008
Last updated
09/24/2012
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