# RURAL THERAPY NETWORK

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

## Provider details

- **NPI number:** 1558114348
- **Authorized official:** MALIA KEALANA BURGESS (OWNER)
- **Authorized official phone:** (406) 272-2440

## Contact information

- **Practice address:** 343 N 300 W, SALT LAKE CITY, UT 84103-1215
- **Practice address phone:** (406) 272-2440
- **Mailing address:** 1935 W 4700 S \# 322, TAYLORSVILLE, UT 84129-1105
- **Mailing address phone:** (406) 272-2440

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | — | NULL | — |
| 101Y00000X | Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | — |

## Other

- **Enumeration date:** 04/10/2024
- **Last updated:** 06/18/2024