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Organization

COUNSELING CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PAUL JOSEPH PETERSON LCSW (DIRECTOR)
(801) 907-0462
Entity
Organization

Contact information

Practice address
1199 S MAIN ST, SUITE 105, CENTERVILLE, UT 84014-2267
(801) 907-0462
(801) 951-1490
Mailing address
123 W 1550 N, BOUNTIFUL, UT 84010-5959
(801) 907-0462
(801) 951-1490

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2645
UT

Other

Enumeration date
10/29/2009
Last updated
12/01/2009
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