# WISE MIND ONLINE THERAPY

> 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
- **Other names:** Wise Mind Online Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891398285
- **Authorized official:** MR. TRAVIS REED STEPHENS LCSW (OWNER / SHARE HOLDER)
- **Authorized official phone:** (208) 243-3332

## Contact information

- **Practice address:** 915 N 510 E, OREM, UT 84097-3374
- **Practice address phone:** (208) 243-3332
- **Mailing address:** 915 N 510 E, OREM, UT 84097-3374
- **Mailing address phone:** (208) 243-3332

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 11/18/2020
- **Last updated:** 11/18/2020