| Utah Center For Psychological Services | |
|
6787 S Redwood Rd West Jordan UT 84084-2404 | |
| (801) 839-5360 | |
| (801) 683-6672 |
| Full Name | Utah Center For Psychological Services |
|---|---|
| Speciality | Psychologist |
| Location | 6787 S Redwood Rd, West Jordan, Utah |
| Authorized Official Name and Position | Casey Mangnall (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 8018395360 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Utah Center For Psychological Services 6787 S Redwood Rd West Jordan UT 84084-2404 Ph: (801) 839-5360 | Utah Center For Psychological Services 6787 S Redwood Rd West Jordan UT 84084-2404 Ph: (801) 839-5360 |
| NPI Number | 1417659186 |
|---|---|
| Provider Enumeration Date | 03/20/2023 |
| Last Update Date | 11/20/2024 |
| Certification Date | 11/20/2024 |
| Medicare PECOS PAC ID | 0042745333 |
|---|---|
| Medicare Enrollment ID | O20241122003593 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417659186 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Casey Mangnall |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740739804 PECOS PAC ID: 1951836246 Enrollment ID: I20241122003633 |
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