Organization
MOUNT OLYMPUS COUNSELING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH DAVID ROACH ED.D, LCMHC (EXECUTIVE DIRECTOR)
(801) 792-7028
Entity
Organization
Contact information
Practice address
4525 S 2300 E STE 102, HOLLADAY, UT 84117-4682
(801) 860-7818
Mailing address
4525 S 2300 E STE 102, HOLLADAY, UT 84117-4682
(801) 860-7818
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
10/19/2020
Last updated
10/19/2020
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