Organization
VISTA COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW B CHECKETTS PH.D., LCSW (PRESIDENT)
(801) 250-9762
Entity
Organization
Contact information
Practice address
1776 S MAIN ST, SALT LAKE CITY, UT 84115-1951
(801) 924-1448
(801) 446-7746
Mailing address
1776 S MAIN ST, SALT LAKE CITY, UT 84115-1951
(801) 924-1448
(801) 446-7746
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
14912
UT
251S00000X
Community/Behavioral Health Agency
Primary
14913
UT
Other
Enumeration date
06/26/2009
Last updated
06/26/2009
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