Organization Name: | ASPEN RIDGE COUNSELING LLC |
NPI Number: | 1104118132 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHRISTOPHER COREY HAKES (MEMBER/MANAGER) |
Mailing Address: | 8537 W 2700 S Ste C Magna |
State: | UT US |
Postal Code: | 840441223 |
Phone Number: | 8014143252 |
Fax Number: | 8017334083 |
NPI Enumeration Date: | 05/10/2011 |
NPI Last Update Date: | 04/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 369489-3501 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |