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Organization
MOUNT OLYMPUS COUNSELING CENTER, INC.
Active
Organization
MOUNT OLYMPUS COUNSELING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH DAVID ROACH ED.D, LCMHC (EXECUTIVE DIRECTOR)
(801) 792-7028
Entity
Organization
Contact information
Practice address
4525 S 2300 E STE 102, HOLLADAY, UT 84117-4682
(801) 860-7818
Mailing address
4525 S 2300 E STE 102, HOLLADAY, UT 84117-4682
(801) 860-7818
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
10/19/2020
Last updated
10/19/2020
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