Renee Vickerman Galliher, PHD
Individual provider Active NPI Clinical Psychologist · River Heights, UT
NPI 1396778734 · NPPES record last updated Apr 18, 2017
Key facts
- NPI
- 1396778734
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 5074236-2501 (UT)
- Practice address
- 700 Mountain View Dr
River Heights, UT 84321-5637 - Phone
- (435) 770-1510
- Fax
- (435) 770-1510
- NPI assigned
- Jul 9, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
965 S 100
Suite 204
Logan, UT 84321-6072
Phone (435) 770-1510
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170517001385 | UT | Practitioner - Clinical Psychologist | 4688941933 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5074236-2501 | UT | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Renee Galliher Psychological Services LLC | Current |
Accepting new patients |
Locations
965 S 100 W
Ste 204
Logan, UT 84321
Phone (435) 753-0707
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 5074236-2501 | UT | Yes |
Addresses
Primary practice location
700 Mountain View Dr
River Heights, UT 84321-5637
Mailing address
700 Mountain View Dr
River Heights, UT 84321-5637
Phone (435) 770-1510
Other providers in River Heights, UT
- Stacy Lyn Bevan
- Jessica Leigh Brown
- Ashlie Leishman I
- Miriam Araceli Luna Dominguez
- Lindsey Hall Menendez
All providers in River Heights, UT · Clinical 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 Apr 18, 2017. 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.