Organization
LIVE WELL COUNSELING SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB K VICKREY (OWNER)
(801) 896-8133
Entity
Organization
Contact information
Practice address
11748 S 3600 W STE 3, SOUTH JORDAN, UT 84095-5922
(801) 896-8133
Mailing address
11748 S 3600 W STE 3, SOUTH JORDAN, UT 84095-5922
(801) 896-8133
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/24/2020
Last updated
08/16/2024
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