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Contact Information

CHARLES L DIVINEY III, MC, LPC, NCC, LLC, DBA CLD3 COUNSELING
LBN CLD3 COUNSELING
352 SOUTH DENVER STREET
SUITE 215
SALT LAKE CITY, UT84111
 Phone: 801-521-4227
 Fax: 801-359-0777
 Website: http://www.cld3.com
 

Specialty

Taxonomy Code Specialty Code Provider Type

Professional

101YP2500X
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Psychiatric/Mental Health

364SP0808X 89 Certified Clinical Nurse Specialist
Indicates primary specialty

NPI Profile & details for CHARLES L DIVINEY III, MC, LPC, NCC, LLC, DBA CLD3 COUNSELING

NPI Number 1235447772
LBN Legal business name CLD3 COUNSELING
DBA Doing business as CHARLES L DIVINEY III, MC, LPC, NCC, LLC, DBA CLD3 COUNSELING
Authorized official DEBRA MORRILL - (BILLING MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/17/2010
Last updated 10/02/2025 - About 8 months ago
Identifiers
UT License # 210158-4405
UT License # 340426-6004
UT License # 5170621-6004
UT License # 6281940-3501
UT Other 340426600001001 BCBS UT
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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