Provider Demographics
NPI:1366720104
Name:DESERET COUNSELING INC
Entity type:Organization
Organization Name:DESERET COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:NOORLANDER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MSW, CSW
Authorized Official - Phone:801-360-3166
Mailing Address - Street 1:1325 S 800 E
Mailing Address - Street 2:SUITE 115 ROOM 115B
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097
Mailing Address - Country:US
Mailing Address - Phone:801-360-3166
Mailing Address - Fax:
Practice Address - Street 1:1325 SOUTH 800 EAST
Practice Address - Street 2:SUITE 115 ROOM 115 B
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097
Practice Address - Country:US
Practice Address - Phone:801-360-3166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-27
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X, 1041C0700X
UT251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty