Provider Demographics
NPI:1154713642
Name:KAIZEN COUNSELING
Entity type:Organization
Organization Name:KAIZEN COUNSELING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VAUGHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLIRON
Authorized Official - Suffix:
Authorized Official - Credentials:MDIV
Authorized Official - Phone:801-486-0908
Mailing Address - Street 1:2144 S LAKELINE DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84109-1425
Mailing Address - Country:US
Mailing Address - Phone:801-486-0908
Mailing Address - Fax:801-998-3302
Practice Address - Street 1:270 12TH ST
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84404-5651
Practice Address - Country:US
Practice Address - Phone:877-526-2247
Practice Address - Fax:801-998-3302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT50028910160101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty