Provider Demographics
NPI:1679357198
Name:VILLA COUNSELING & COACHING
Entity type:Organization
Organization Name:VILLA COUNSELING & COACHING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARRILEE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCHANAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:435-640-9233
Mailing Address - Street 1:3200 S 2000 E
Mailing Address - Street 2:
Mailing Address - City:SLC
Mailing Address - State:UT
Mailing Address - Zip Code:84109-2602
Mailing Address - Country:US
Mailing Address - Phone:435-640-9233
Mailing Address - Fax:801-747-6858
Practice Address - Street 1:1565 E 3300 S
Practice Address - Street 2:
Practice Address - City:SLC
Practice Address - State:UT
Practice Address - Zip Code:84106-3370
Practice Address - Country:US
Practice Address - Phone:801-699-3133
Practice Address - Fax:801-747-6858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty