Organization
PALISADES COUNSELING LLC
Active
Organization
PALISADES COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN EDGINGTON PHD (OWNER)
(801) 356-0014
Entity
Organization
Contact information
Practice address
3319 N UNIVERSITY AVE STE 100, PROVO, UT 84604-4447
(801) 356-0014
Mailing address
3319 N UNIVERSITY AVE STE 100, PROVO, UT 84604-4447
(801) 356-0014
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
09/26/2023
Last updated
09/26/2023
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