Provider Demographics
NPI:1962266148
Name:ON TRACK COUNSELING LLC
Entity type:Organization
Organization Name:ON TRACK COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:F
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:801-686-9334
Mailing Address - Street 1:2800 S 1200 W
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:UT
Mailing Address - Zip Code:84302-4226
Mailing Address - Country:US
Mailing Address - Phone:801-686-9334
Mailing Address - Fax:801-326-0225
Practice Address - Street 1:1893 E SKYLINE DR STE 102
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-5382
Practice Address - Country:US
Practice Address - Phone:801-686-9334
Practice Address - Fax:801-326-0225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-08
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health