# DOUG AND BETTY FORD COUNSELING LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316339443
- **Authorized official:** CHERYL IPSON (BILLNG MANAGER)
- **Authorized official phone:** (801) 921-9495

## Contact information

- **Practice address:** 216 COUGAR CIR, ELK RIDGE, UT 84651-9565
- **Practice address phone:** (801) 921-9495
- **Mailing address:** PO BOX 222, SALEM, UT 84653-0222
- **Mailing address phone:** (801) 921-9495

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 3315546004 | UT | Yes |
| 1041C0700X | Clinical Social Worker | 49290043501 | UT | — |

## Other

- **Enumeration date:** 02/26/2015
- **Last updated:** 02/26/2015