Family Mental Health – Psychologist in St George, UT

Key facts

NPI: 1144899170
Entity type: Organization (NPI type 2)
Primary specialty: Psychologist 103T00000X
Legal business name: FAMILY MENTAL HEALTH
Practice address: 1060 S Main St Ste 301
St George, UT 84770-5260
Phone: (435) 650-9854
Fax: (435) 200-3579
NPI assigned: Jun 23, 2021
Organization subpart: No

Authorized official

Name: Austin Kyle Elder, PHD NPI 1881651115
Title: Licensed Clinical Psychologist
Phone: (435) 650-9854

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

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

Austin Kyle Elder, PHD Psychologist · St George, UT · NPI 1881651115

Medicare reassignment NPD Authorized official PSYCHOLOGIST · UT

Medicare participation

Medicare fee-for-service enrollment: Enrolled in UT

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20210824002287	UT	Part B Supplier - Clinic/Group Practice	7315342649	Receives reassigned benefits from 1 practitioner Practice locations: St George, UT

National Provider Directory

Locations

1060 S Main St
Ste 301
St George, UT 84770
Phone (435) 650-9854

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Psychologist Group: 193400000X SINGLE SPECIALTY GROUP	103T00000X			Yes

Addresses

Primary practice location

1060 S Main St Ste 301
St George, UT 84770-5260

Mailing address

2210 E 550 N
St George, UT 84790-1522
Phone (435) 650-9854

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 25, 2024.

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721865600000",
    "number": "1144899170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 E 550 N",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847901522",
            "telephone_number": "435-650-9854",
            "fax_number": "435-200-3579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 S MAIN ST STE 301",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847705260",
            "telephone_number": "435-650-9854",
            "fax_number": "435-200-3579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-23",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A",
        "authorized_official_last_name": "ELDER",
        "authorized_official_first_name": "AUSTIN",
        "authorized_official_middle_name": "KYLE",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "435-650-9854",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

All providers in St George, UT · Psychologist in Utah

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 25, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.