Provider Demographics
NPI:1285291708
Name:SUMMIT PEAK COUNSELING LLC
Entity type:Organization
Organization Name:SUMMIT PEAK COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:WELSH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:385-312-0282
Mailing Address - Street 1:3494 N 350 W
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-4174
Mailing Address - Country:US
Mailing Address - Phone:801-867-6669
Mailing Address - Fax:
Practice Address - Street 1:782 E PIONEER RD
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-5734
Practice Address - Country:US
Practice Address - Phone:385-312-0282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty