NPIMap

Organization Active NPI

Intermountain Mental Health, Inc.

  • Psychologist
  • Millcreek, UT
National Provider Identifier
1588847008
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2774677-2501 Issued in UT
Legal business name
INTERMOUNTAIN MENTAL HEALTH, INC.
Practice address
5012 S Timber Way Unit 206
Millcreek, UT 84117-5875
Phone
(801) 673-4841
NPI assigned
Dec 6, 2007
Last updated
Jan 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Authorized official

Name
Dr. Morris N. Lewis Jr., PHDNPI 1740274299
Title
President
Phone
(801) 673-4841

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2774677-2501 UT Primary

Addresses

Primary practice location

5012 S Timber Way Unit 206
Millcreek, UT 84117-5875

Mailing address

PO Box 57885
Murray, UT 84157-0885
Phone (801) 673-4841

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040213000279 UT Part B Supplier - Clinic/Group Practice 6002718483 Receives reassigned benefits from 1 practitioner
Practice locations: Provo, UT; Salt Lake City, UT; Sandy, UT; South Ogden, UT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611273600000",
    "number": "1588847008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 57885",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841570885",
            "telephone_number": "801-673-4841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5012 S TIMBER WAY UNIT 206",
            "city": "MILLCREEK",
            "state": "UT",
            "postal_code": "841175875",
            "telephone_number": "801-673-4841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN MENTAL HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-06",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "MORRIS",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-673-4841",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "UT",
            "license": "2774677-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millcreek, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare 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.