Provider Demographics
NPI:1871145227
Name:PINYON PINE COUNSELING
Entity type:Organization
Organization Name:PINYON PINE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:L
Authorized Official - Last Name:SKOUSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:435-668-4983
Mailing Address - Street 1:1630 E 2450 S UNIT 121
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-6234
Mailing Address - Country:US
Mailing Address - Phone:435-668-4983
Mailing Address - Fax:
Practice Address - Street 1:1240 E 100 S BLDG 23
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-3001
Practice Address - Country:US
Practice Address - Phone:435-652-1202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health