| Organization Name: | ALPINE COUNSELING CENTER |
| NPI Number: | 1154778066 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DOUGLAS NIELSEN (OWNER) |
| Mailing Address: | 475 W 50 N American Fork |
| State: | UT US |
| Postal Code: | 840032265 |
| Phone Number: | 8017563664 |
| Fax Number: | 8017563698 |
| NPI Enumeration Date: | 05/20/2016 |
| NPI Last Update Date: | 05/20/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 85120196004 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |