Wasatch Behavioral Health Special Service District

NPI #1356357115 in Provo, Utah

Provider Information

NPI Number: 1356357115
Entity Type: Organization
Organization Name: Wasatch Behavioral Health Special Service District
Primary Specialty: Community/Behavioral Health
Enumeration Date: Aug 1, 2006
Last Updated: Apr 30, 2021

Practice Location

Address: 750 N FREEDOM BLVD
Address 2: SUITE 300
City: Provo
State: Utah
ZIP Code: 84601
Phone: (801) 373-4760

Authorized Official

Name: MR. DORAN WILLIAMS, LCSW
Title: ASSOCIATE DIRECTORE
Phone: (801) 373-4760

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X
Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder	261QR0405X
Community/Behavioral Health	251S00000X	Primary

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