Psychology Specialists of Utah LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

PSYCHOLOGY SPECIALISTS OF UTAH LLC

Practice address

87 N 600 E
Centerville, UT 84014-2020

Phone

(405) 315-5756

NPI assigned

Jan 22, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Carl Robert Edgington, PH.D.NPI 1427285444

Title

Owner

Phone

(405) 315-5756

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carl Robert Edgington, PHD

  • Clinical Psychologist
  • Salt Lake City, UT
  • NPI 1427285444
  NPD Authorized official
• Taryn Kathleen Nicksic-Springer, PHD

  • Psychologist
  • SLC, UT
  • NPI 1558550046
  NPD (past)
• Natalie Heersink Roth, PH.D.

  • Clinical Psychologist
  • Salt Lake City, UT
  • NPI 1699727164
  NPD (past)

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

{
    "created_epoch": "1611273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611273600000",
    "number": "1649860644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 N 600 E",
            "city": "CENTERVILLE",
            "state": "UT",
            "postal_code": "840142020",
            "telephone_number": "405-315-5756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 N 600 E",
            "city": "CENTERVILLE",
            "state": "UT",
            "postal_code": "840142020",
            "telephone_number": "405-315-5756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGY SPECIALISTS OF UTAH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-22",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A",
        "authorized_official_last_name": "EDGINGTON",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-315-5756",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce G Pitt, DMD
• Jason Pitt, DDS
• Jerem Pitt, DDS
• Kylie Danielle Platz, RDH
• Andrew Richard Poll, MSW
• Porter Raymond
• Douglas E Rechis, REGISTERED PHARMACIS
• Karen Redd, LCMHC
• Reid Physical Therapy
• Nanette F Reid, PT

• Clinical Psychologist in Centerville, UT
• Providers in Centerville, UT by specialty
• Clinical Psychologist in Utah

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.