Organization
CRESCENT COUNSELING & CONSULTING,, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE CHRISTINE WILCOX LCSW, LASUDC (SINGLE OWNER LLC)
(385) 235-6926
Entity
Organization
Contact information
Practice address
940 E. SOUTH UNION AVENUE, MIDVALE, UT 84047-2302
(385) 235-6926
(801) 255-7284
Mailing address
940 E. SOUTH UNION AVENUE, MIDVALE, UT 84047-2302
(385) 235-6926
(801) 255-7284
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
270969-6006
UT
1041C0700X
Clinical Social Worker
Primary
270969-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
788007788032
—
UT
Enumeration date
06/28/2007
Last updated
11/06/2018
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