Active NPI
Lisa M Mountain, PH.D.
- Psychologist
- Salt Lake City, UT
National Provider Identifier
1467622696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2797320-2501
- Practice address
- 1400 Foothill Dr
Suite 24
Salt Lake City, UT 84108-2327 - Phone
- (801) 581-0422
- Fax
- (801) 581-0764
- NPI assigned
- Mar 4, 2008
- Last updated
- Mar 4, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2797320-2501 | UT | Primary |
Addresses
Primary practice location
1400 Foothill Dr
Suite 24
Salt Lake City, UT 84108-2327
Mailing address
1400 Foothill Dr
Suite 24
Salt Lake City, UT 84108-2327
Phone (801) 581-0422
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 20, 2026 through May 20, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2797320-2501 | UT | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204588800000",
"number": "1467622696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 FOOTHILL DR",
"address_2": "SUITE 24",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841082327",
"telephone_number": "801-581-0422",
"fax_number": "801-581-0764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 FOOTHILL DR",
"address_2": "SUITE 24",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841082327",
"telephone_number": "801-581-0422",
"fax_number": "801-581-0764"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUNTAIN",
"first_name": "LISA",
"middle_name": "M",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-04",
"last_updated": "2008-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "UT",
"license": "2797320-2501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.