# BREAKAWAY COUNSELING, LLC

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

## Provider details

- **NPI number:** 1972485035
- **Authorized official:** LAURA MATSON LCSW (PRESIDENT)
- **Authorized official phone:** (801) 633-2507

## Contact information

- **Practice address:** 489 W SOUTH JORDAN PKWY STE 256, SOUTH JORDAN, UT 84095-3979
- **Practice address phone:** (801) 871-5799
- **Mailing address:** 11153 S DEVON VIEW DR, SOUTH JORDAN, UT 84095-4142
- **Mailing address phone:** (801) 633-2507

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 07/21/2025
- **Last updated:** 07/21/2025