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Organization

LIFE CHANGING THERAPY

Active
Parent organization
YES
Other names
Richard H. Bashaw LCSW, LLC and Associates
Organization subpart
Yes

Provider details

NPI number
Legal business name
YES
Authorized official
MR. RICHARD HOLLIS BASHAW MSW (AGENCY MANAGER)
(801) 918-9688
Entity
Organization

Contact information

Practice address
1800 S WEST TEMPLE, SUITE A332, SALT LAKE CITY, UT 84115-1851
(801) 918-9688
(801) 446-7874
Mailing address
1800 S WEST TEMPLE, SUITE A332, SALT LAKE CITY, UT 84115-1851
(801) 918-9688
(801) 446-7874

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0683
UT

Other

Enumeration date
12/20/2008
Last updated
12/20/2008
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