Provider Demographics
NPI:1225832702
Name:FIRST LIGHT TRAUMA COUNSELING
Entity type:Organization
Organization Name:FIRST LIGHT TRAUMA COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:801-636-7796
Mailing Address - Street 1:2721 N HWY 89 STE 200
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VIEW
Mailing Address - State:UT
Mailing Address - Zip Code:84404-6259
Mailing Address - Country:US
Mailing Address - Phone:801-624-6996
Mailing Address - Fax:
Practice Address - Street 1:2721 N HWY 89 STE 200
Practice Address - Street 2:
Practice Address - City:PLEASANT VIEW
Practice Address - State:UT
Practice Address - Zip Code:84404-6259
Practice Address - Country:US
Practice Address - Phone:801-624-6996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty