Provider Demographics
NPI:1841022910
Name:CHANNELING EXPANSION COUNSELING
Entity type:Organization
Organization Name:CHANNELING EXPANSION COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAMILLE
Authorized Official - Middle Name:THEA
Authorized Official - Last Name:MISKIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-436-7242
Mailing Address - Street 1:114 W 450 S
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-2430
Mailing Address - Country:US
Mailing Address - Phone:801-436-7242
Mailing Address - Fax:
Practice Address - Street 1:498 N KAYS DR STE 220
Practice Address - Street 2:
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037-4189
Practice Address - Country:US
Practice Address - Phone:801-436-7242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHANNELING EXPANSION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-17
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty