Individual provider Active NPI

Lisa O'Donnal, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Richfield, UT
National Provider Identifier
1124584867
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
364770-4405 Issued in UT
Practice address
236 S 100 E
Richfield, UT 84701-2644
Phone
(435) 896-9584
NPI assigned
Feb 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 364770-4405 UT Primary

Addresses

Primary practice location

236 S 100 E
Richfield, UT 84701-2644

Mailing address

152 N 400 W
Ephraim, UT 84627-5549
Phone (435) 283-8400

Other practice location 1

750 N Freedom Blvd
Provo, UT 84601-1677
Phone (801) 373-4760

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200721003407 UT Practitioner - Nurse Practitioner 6507280724 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wasatch Behavioral Health Special Service DistrictGroup PAC ID 2567367915, 84 clinicians

Practice addresses (Care Compare)

750 N Freedom Blvd
Provo, UT 84601-1677
Phone (801) 373-4760

Hospital & facility affiliations

  • Intermountain Health Heber Valley Hospital Hospital, Heber City, UT, CCN 461307

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
364770-4405UTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wasatch Behavioral Health Special Service District CurrentSince Jul 6, 2020 Accepting new patients
Wasatch Behavioral Health Special Service District CurrentSince Jul 6, 2020 Accepting new patients
Central Utah Counseling Center PastSince May 1, 2026 Accepting new patients

Locations

55 S 5th E
Heber City, UT 84032
Phone (435) 654-2700

750 N Freedom Blvd
Provo, UT 84601
Phone (801) 373-0639

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1124584867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 N 400 W",
            "city": "EPHRAIM",
            "state": "UT",
            "postal_code": "846275549",
            "telephone_number": "435-283-8400",
            "fax_number": "435-283-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 S 100 E",
            "city": "RICHFIELD",
            "state": "UT",
            "postal_code": "847012644",
            "telephone_number": "435-896-9584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 N Freedom Blvd",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846011677",
            "country_code": "US",
            "telephone_number": "801-373-4760",
            "fax_number": "801-373-0639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'DONNAL",
        "first_name": "LISA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-19",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "364770-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richfield, UT

Sources for this page

Verify at the official NPI Registry.