| Organization Name: | SYNERGISM COUNSELING, LLC |
| NPI Number: | 1124313481 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHELLE GREENE (ONWER) |
| Mailing Address: | 11487 S 700 E Draper |
| State: | UT US |
| Postal Code: | 840209067 |
| Phone Number: | 8013501671 |
| Fax Number: | 8014466511 |
| NPI Enumeration Date: | 06/15/2011 |
| NPI Last Update Date: | 10/03/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |