Individual provider Active NPI

Emma Mansour, PHD

  • Psychologist
  • Farmington, UT
National Provider Identifier
1043611486
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
8781073-2501 Issued in UT
Practice address
1433 N 1075 W Ste 120
Farmington, UT 84025-2746
Phone
(385) 219-4980
NPI assigned
Sep 4, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Psychologist 103T00000X 8781073-2501 UT Primary

Addresses

Primary practice location

1433 N 1075 W Ste 120
Farmington, UT 84025-2746

Mailing address

1170 Shepard CRK Pkwy
Farmington, UT 84025-2851
Phone (801) 232-1161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140926000341 UT Practitioner - Clinical Psychologist 3072733047 Reassigns benefits to 1 organization
Receives reassigned benefits from 2 practitioners
Practice locations: Farmington, UT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Utah School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1433 N 1075 W
120 Life Matters Counseling and Psychology
Farmington, UT 84025-2746
Phone (385) 219-4980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
8781073-2501UTMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Human Potential Inc CurrentSince Sep 8, 2014 Accepting new patients
Life Matters Counseling and Psychological Services LLC CurrentSince Jun 8, 2025 Accepting new patients
Center for Human Potential PastSince Sep 8, 2014 Accepting new patients

Locations

1433 N 1075 W
Ste 120
Farmington, UT 84025
Phone (385) 219-4980

265 E 100 S
Ste 250
Slc, UT 84111
Phone (801) 483-2447

Practitioners & affiliated clinicians

Practitioners 2

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

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1043611486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 SHEPARD CRK PKWY",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252851",
            "telephone_number": "801-232-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1433 N 1075 W STE 120",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252746",
            "telephone_number": "385-219-4980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "EMMA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-04",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "UT",
            "license": "8781073-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, UT

Sources for this page

Verify at the official NPI Registry.