Lisa Michelle Sugerman-Hermansen, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

6278375-2501 Issued in UT

Practice address

3838 S 700 E Ste 101
Salt Lake City, UT 84106-1494

Phone

(801) 716-4284

Fax

(801) 433-0691

NPI assigned

Oct 15, 2010

Last updated

Oct 29, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Lisa Michelle Sugerman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Steinmann Institute, LLC

  • Clinical Neuropsychologist
  • Salt Lake City, UT
  • NPI 1215215181
  NPD Authorized official
• Psychiatry Consulting & Research, LLC

  • Psychiatry Physician
  • Salt Lake City, UT
  • NPI 1487961793
  NPD (past)

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1619287208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 S 700 E STE 101",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841061494",
            "telephone_number": "801-716-4284",
            "fax_number": "801-433-0691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 S 700 E STE 101",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841061494",
            "telephone_number": "801-716-4284",
            "fax_number": "801-433-0691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUGERMAN-HERMANSEN",
        "first_name": "LISA",
        "middle_name": "MICHELLE",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-15",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "UT",
            "license": "6278375-2501",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "6278375-2501",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "SUGERMAN",
            "middle_name": "MICHELLE",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sugarhouse Center Fo Healing
• Sugarhouse Dental Inc (Sleep Well Utah)
• Sugarhouse Foot Care Inc
• Sugarhouse Vision Clinic
• Steven Gregory Sugden, M.D.
• Steven Alan Sugerman, PA
• Irene Suh
• Faalaa Suisala
• Elif Suleymanova
• Amy E Sullivan, MD

• Clinical Neuropsychologist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Clinical Neuropsychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.