# DIVINE AWAKENING CENTER LLC

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

## Provider details

- **NPI number:** 1710670617
- **Authorized official:** BRANDEE DOWNES LMFT (CLINICAL DIRECTOR)
- **Authorized official phone:** (385) 319-1107

## Contact information

- **Practice address:** 121 W 200 S, FARMINGTON, UT 84025-2327
- **Practice address phone:** (385) 319-1107
- **Mailing address:** 121 W 200 S, FARMINGTON, UT 84025-2327
- **Mailing address phone:** (385) 319-1107

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |
| 171400000X | Health & Wellness Coach | — | NULL | — |
| 171400000X | Health & Wellness Coach | — | — | — |

## Other

- **Enumeration date:** 05/29/2023
- **Last updated:** 11/01/2023