Provider Demographics
NPI:1417789967
Name:INNER GROWTH COUNSELING SERVICES
Entity type:Organization
Organization Name:INNER GROWTH COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:LIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:CMHC
Authorized Official - Phone:801-663-1006
Mailing Address - Street 1:397 S 1125 W
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-5230
Mailing Address - Country:US
Mailing Address - Phone:801-663-1006
Mailing Address - Fax:
Practice Address - Street 1:2363 N HILL FIELD RD STE 122
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-6958
Practice Address - Country:US
Practice Address - Phone:801-663-1006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty