| Organization Name: | NORTHERN UTAH MENTAL COUNSELING INC |
| NPI Number: | 1063843308 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KANG WOO LEE (PRES.) |
| Mailing Address: | 49 E 200 S Clearfield |
| State: | UT US |
| Postal Code: | 840151047 |
| Phone Number: | 8017790095 |
| Fax Number: | 8017790255 |
| NPI Enumeration Date: | 12/12/2013 |
| NPI Last Update Date: | 03/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |