Organization
MOMENTUM COUNSELING SERVICES, CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER STARK LCMHC (OWNER)
(801) 518-9362
Entity
Organization
Contact information
Practice address
11075 S STATE ST STE 13, SANDY, UT 84070-5193
(801) 948-0939
Mailing address
1446 E ANVIL DR, DRAPER, UT 84020-8832
(801) 898-7502
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8598755-6004
UT
106H00000X
Marriage & Family Therapist
6153954-3902
UT
Other
Enumeration date
05/03/2018
Last updated
05/03/2018
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