Individual provider Active NPI

Lori Neeleman, PHD

  • Clinical Psychologist
  • Salt Lake City, UT
National Provider Identifier
1992000145
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5408755-2501 Issued in UT
Practice address
389 South 900 East
Salt Lake City, UT 84102-2310
Phone
(385) 282-2000
Fax
(385) 282-2001
NPI assigned
Jan 19, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 5408755-2501 UT
Clinical Psychologist 103TC0700X 5408755-2501 UT Primary

Addresses

Primary practice location

389 South 900 East
Salt Lake City, UT 84102-2310

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (385) 282-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120629000486 UT Practitioner - Clinical Psychologist 6709041452 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

440 D St
Suite 200
Salt Lake City, UT 84103-2827
Phone (801) 408-3617

5770 S 250
Suite 340
Salt Lake City, UT 84107-8163
Phone (801) 314-2400

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince May 14, 2012 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
University of Utah CurrentSince May 23, 2020 Accepting new patients
University of Utah CurrentSince May 23, 2020 Accepting new patients
Ihc Health Services, Inc. CurrentSince May 14, 2012 Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

5770 S 250 E
Ste 340
Salt Lake City, UT 84107
Phone (801) 314-2400

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

389 S 900 E
Slc, UT 84102
Phone (385) 282-2000

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

325 8th Ave
Slc, UT 84143
Phone (801) 321-1767

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1295395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1992000145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "385-282-2000",
            "fax_number": "385-282-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "389 SOUTH 900 EAST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022310",
            "telephone_number": "385-282-2000",
            "fax_number": "385-282-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEELEMAN",
        "first_name": "LORI",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-19",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "UT",
            "license": "5408755-2501",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "5408755-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.