Organization
CHARLES L DIVINEY III MC LPC NCC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA MORRILL (BILLING MANAGER)
(801) 916-1645
Entity
Organization
Contact information
Practice address
352 S DENVER ST STE 350, SLC, UT 84111-3059
(801) 521-4227
(801) 359-0777
Mailing address
PO BOX 3872, SLC, UT 84110-3872
(801) 521-4227
(801) 359-0777
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
340426-6004
UT
101YP2500X
Professional Counselor
5170621-6004
UT
1041C0700X
Clinical Social Worker
6281940-3501
UT
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
210158-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
340426600001001
BCBS UT
UT
Enumeration date
09/17/2010
Last updated
10/02/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us