Provider Demographics
NPI:1699955393
Name:CONNECTING PLACE COUNSELING CENTER PLLC
Entity type:Organization
Organization Name:CONNECTING PLACE COUNSELING CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHEIF THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:BASSETT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-768-1725
Mailing Address - Street 1:2845 WILLOW WAY
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-5164
Mailing Address - Country:US
Mailing Address - Phone:801-768-1725
Mailing Address - Fax:801-768-1725
Practice Address - Street 1:3375 W MAYFLOWER WAY STE A
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-3135
Practice Address - Country:US
Practice Address - Phone:801-768-1725
Practice Address - Fax:888-891-8164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6774648-0162251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health