Organization
INTEGRATIVE COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY FOLSOM MANGUM LCMHC (OWNER)
(801) 793-0620
Entity
Organization
Contact information
Practice address
510 E SEGO LILY DR, SANDY, UT 84070-3546
(801) 793-0620
(844) 440-5778
Mailing address
510 E SEGO LILY DR, SANDY, UT 84070-3546
(801) 793-0620
(844) 440-5778
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5828209-6004
LCMHC
UT
Enumeration date
04/21/2020
Last updated
04/21/2020
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