Organization
ADVANCED AWARENESS COUNSELING, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH V MACIAS JD (OWNER)
(408) 420-5730
Entity
Organization
Contact information
Practice address
4125 N CANYON RD, PROVO, UT 84604-5015
(408) 420-5730
Mailing address
4141 S HIGHLAND DR, SUITE 208, SALT LAKE CITY, UT 84124-2642
(408) 420-5730
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8173984-6009
UT
251S00000X
Community/Behavioral Health Agency
8173984-6009
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568720472
—
UT
Enumeration date
07/27/2015
Last updated
07/27/2015
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