Basic Information
| Provider Information | |||||||||
| NPI: | 1124682018 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | K2 COUNSELING & CONSULTING | ||||||||
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| Mailing Information | |||||||||
| Address1: | 498 N 900 W STE 200 | ||||||||
| Address2: | |||||||||
| City: | KAYSVILLE | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840374153 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015254645 | ||||||||
| FaxNumber: | 8017797808 | ||||||||
| Practice Location | |||||||||
| Address1: | 2363 N HILL FIELD RD STE 5 | ||||||||
| Address2: | |||||||||
| City: | LAYTON | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840416910 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015254645 | ||||||||
| FaxNumber: | 8017797808 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2019 | ||||||||
| LastUpdateDate: | 10/31/2022 | ||||||||
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| AuthorizedOfficialLastName: | KINIKINI | ||||||||
| AuthorizedOfficialFirstName: | KARSON | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER, THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 8016283092 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | CMHC | ||||||||
| NPICertificationDate: | 10/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 12113466 | 01 | CAQH | OTHER |