Soul Logic Counseling

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SOUL LOGIC COUNSELING

Practice address

4434 S Highland Dr
Millcreek, UT 84124-3533

Phone

(385) 321-3109

NPI assigned

Sep 6, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Susan Michelle Bollow, LCSWNPI 1275769259

Title

Owner/ Clinical Director

Phone

(385) 321-3109

Specialties & licenses 1

Addresses

Other names 1

• Susan Bollow Counseling Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan Michelle Bollow, LCSW

  • Clinical Social Worker
  • Millcreek, UT
  • NPI 1275769259

  Clinical

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1725580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725580800000",
    "number": "1124853239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4434 S HIGHLAND DR",
            "city": "MILLCREEK",
            "state": "UT",
            "postal_code": "841243533",
            "telephone_number": "385-321-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4434 S HIGHLAND DR",
            "city": "MILLCREEK",
            "state": "UT",
            "postal_code": "841243533",
            "telephone_number": "385-321-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUL LOGIC COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-06",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A",
        "authorized_official_last_name": "BOLLOW",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER/ CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "385-321-3109",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Susan Bollow Counseling",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Karl Scott Smith III
• Katherine Bradshaw Smith, NP
• Katherine Jayne Kettler Smith, M.A. CCC-SLP
• Lesa A Smith, MSW, CSW
• Solstice Trauma Healing LLC
• Soul Pathways Wellness, LLC
• Jorri Lee Sparks, MSN, APRN, FNP-BC
• Marshall Spiegel, DO
• Zoe Staley, RBT
• Steady Currents Therapy

• All providers in Millcreek, UT
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.