Charles L Diviney III Mc Lpc Ncc LLC

NPI #1235447772 in Slc, Utah

Provider Information

NPI Number: 1235447772
Entity Type: Organization
Organization Name: Charles L Diviney III Mc Lpc Ncc LLC
Primary Specialty: Counselor - Professional
Enumeration Date: Sep 17, 2010
Last Updated: Oct 2, 2025

Practice Location

Address: 352 S DENVER ST STE 350
City: Slc
State: Utah
ZIP Code: 84111-3059
Phone: (801) 521-4227

Authorized Official

Name: DEBRA MORRILL
Title: BILLING MANAGER
Phone: (801) 916-1645

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary
Social Worker - Clinical — Clinical	1041C0700X
Clinical Nurse Specialist - Psychiatric/Mental Health — Psychiatric/Mental Health	364SP0808X

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