Gary Tyler Lefevor, PHD

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

11642799-2501 Issued in UT

Practice address

6405 Old Main Hill
Logan, UT 84322-1624

Phone

(435) 797-3401

Fax

(844) 308-5865

NPI assigned

Feb 7, 2017

Last updated

Mar 13, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 13, 2024 through Nov 13, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Utah State University

  dba Sorenson Legacy Foundation Center for Clinical Excellence

  • Specialist
  • Logan, UT
  • NPI 1447715701
  NPD (past)

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1477091650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6405 OLD MAIN HILL",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843226405",
            "telephone_number": "435-797-3401",
            "fax_number": "844-308-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 OLD MAIN HILL",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843221624",
            "telephone_number": "435-797-3401",
            "fax_number": "844-308-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEFEVOR",
        "first_name": "GARY",
        "middle_name": "TYLER",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-07",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "UT",
            "license": "11642799-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Ledesma
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• Allie Leezer, CSW
• Evan J Lefevre,, D.C., P.C.
• Teneya Kay Lefors, MSW, CSW
• Legrand Bingham Inc
• Legrand Bingham, Inc.
• Kamryn Curtis Leishman

• Counseling Psychologist in Logan, UT
• Providers in Logan, UT by specialty
• Counseling Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.

Verify at the official NPI Registry.