CHARLES L DIVINEY III MC LPC NCC NPI 1235447772

NPI Information

  • NPI: 1235447772
  • Provider Name: CHARLES L DIVINEY III MC LPC NCC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Organization
  • Address: 352 SO DENVER ST.
    #215
    SLC, UT
    ZIP 84110
  • Phone: (801) 521-4227

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NPI Details

CHARLES L DIVINEY III MC LPC NCC is a professional counselor in Slc, UT. CHARLES L DIVINEY III MC LPC NCC NPI is 1235447772. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

352 SO DENVER ST.
#215
SLC, UT
ZIP 84110-872
Phone: (801) 521-4227
Fax: (801) 359-0777

The provider's authorized official is Charles L Diviney Iii Mc Lcmhc Ncc, Phd .
The authorized official title is Owner/therapist and has the following contact phone number (801) 521-4227.

The enumeration date for this NPI number is 9/17/2010 and was last updated on 11/21/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YP2500XCounselorProfessional5170621-6004UTAHNo
21041C0700XSocial WorkerClinical6281940-3501UTAHNo
3364SP0808XClinical Nurse SpecialistPsychiatric/Mental Health210158-4405UTAHNo
4101YP2500XCounselorProfessional340426-6004UTAHYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1340426600001001OTHERUTAHBCBS UT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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