Provider Demographics
NPI:1285441774
Name:NEW VENTURE THERAPY PLLC
Entity type:Organization
Organization Name:NEW VENTURE THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL MENTAL HEALTH COUNSE
Authorized Official - Prefix:
Authorized Official - First Name:AMANDAMAE
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMMERS
Authorized Official - Suffix:
Authorized Official - Credentials:CMHC
Authorized Official - Phone:435-775-0009
Mailing Address - Street 1:1601 COLAVITO WAY
Mailing Address - Street 2:
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074-8979
Mailing Address - Country:US
Mailing Address - Phone:435-775-0009
Mailing Address - Fax:
Practice Address - Street 1:1244 N MAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-5009
Practice Address - Country:US
Practice Address - Phone:435-775-0009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty