Susan Jones Carcelli, PH.D.
Individual provider Active NPI Clinical Psychologist · Ogden, UT
NPI 1881751998 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1881751998
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 871141372501 (UT)
- Practice address
- 425 E 5350 S Ste 370
Ogden, UT 84405-7410 - Phone
- (801) 317-1884
- NPI assigned
- Jan 2, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 871141372501 | UT | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bear River Mental Health Services Inc | Past |
Accepting new patients | |
| Carcelli & Carcelli PC | Clinical | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 871141372501 | UT | Yes |
Addresses
Primary practice location
425 E 5350 S Ste 370
Ogden, UT 84405-7410
Mailing address
PO Box 150307
Ogden, UT 84415-0307
Phone (801) 317-1884
Other providers in Ogden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.