Provider Demographics
NPI:1033954557
Name:MACEDONE COUNSELING
Entity type:Organization
Organization Name:MACEDONE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:MACEDONE
Authorized Official - Suffix:JR
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:385-201-7236
Mailing Address - Street 1:3130 W MAPLE LOOP DR STE GL100
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-5790
Mailing Address - Country:US
Mailing Address - Phone:385-201-7236
Mailing Address - Fax:
Practice Address - Street 1:3130 W MAPLE LOOP DR STE GL100
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-5790
Practice Address - Country:US
Practice Address - Phone:385-201-7236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)