Individual provider Active NPI

Le Q Ngu, PHD

  • Clinical Psychologist
  • Murray, UT
National Provider Identifier
1245456797
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
70577322501 Issued in UT
Practice address
5801 S Fashion Blvd Ste 200
Murray, UT 84107-6162
Phone
(801) 875-2128
Fax
(855) 373-2007
NPI assigned
Apr 17, 2007
Last updated
Sep 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 70577322501 UT Primary

Addresses

Primary practice location

5801 S Fashion Blvd Ste 200
Murray, UT 84107-6162

Mailing address

7419 S Creekview CV
Cottonwood Heights, UT 84121-4769
Phone (801) 842-9255

Other practice location 1

1575 W 7000 S
West Jordan, UT 84084-3431
Phone (801) 875-2128

Other identifiers 1

IdentifierTypeStateIssuer
U000074083OtherUTPTAN

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
I20100729000235 UT Practitioner - Clinical Psychologist 9234212598 Practice locations: Murray, UT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5882 S 900
Suite 104
Murray, UT 84121-5693
Phone (801) 875-2128

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
70577322501UTMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Le Ngu, Licensed Psychologist CurrentSince Jul 8, 2013 Accepting new patients
Center for Human Potential PastSince Dec 15, 2019 Accepting new patients
Center for Human Potential Inc PastSince Jun 1, 2007 Accepting new patients

Networks

  • UT PPO D-SNP
  • UT PPO

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1245456797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7419 S CREEKVIEW CV",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "841214769",
            "telephone_number": "801-842-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 S FASHION BLVD STE 200",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841076162",
            "telephone_number": "801-875-2128",
            "fax_number": "855-373-2007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1575 W 7000 S",
            "address_purpose": "LOCATION",
            "city": "West Jordan",
            "state": "UT",
            "postal_code": "840843431",
            "country_code": "US",
            "telephone_number": "801-875-2128",
            "fax_number": "206-337-6197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGU",
        "first_name": "LE",
        "middle_name": "Q",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "70577322501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "U000074083",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.