Organization
RADIANT MOON, PLLC
Active
Other names
Radiant Mind Wellness, Kathryn Wingard Creative Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHRYN WINGARD LCMHC, ATR-BC (OWNER/CLINICAL DIRECTOR)
(385) 346-0031
Entity
Organization
Contact information
Practice address
940 E SOUTH UNION AVE, MIDVALE, UT 84047-2302
(385) 346-0031
(385) 446-0973
Mailing address
5622 S WALDEN GLEN DR, SALT LAKE CITY, UT 84123-7925
(385) 346-0031
(385) 446-0973
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
221700000X
Art Therapist
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
10/25/2021
Last updated
12/19/2023
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