Lisa Michelle Sugerman-hermansen, PHD is a medicare enrolled "Clinical Neuropsychologist" provider in Salt Lake City, Utah. Her current practice location is
3838 S 700 E Ste 101, Salt Lake City, Utah. You can reach out to her office (for appointments etc.) via phone at
(801) 716-4284.
Lisa Michelle Sugerman-hermansen is licensed to practice in Utah (license number 6278375-2501) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1619287208.
Healthcare Provider's Profile
Full Name | Lisa Michelle Sugerman-hermansen |
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Gender | Female |
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Speciality | Clinical Neuropsychologist |
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Location | 3838 S 700 E Ste 101, Salt Lake City, Utah |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1619287208
- Provider Enumeration Date: 10/15/2010
- Last Update Date: 10/29/2024
Medicare PECOS Information:
- PECOS PAC ID: 8224218516
- Enrollment ID: I20110203000283
Medical Identifiers
Medical identifiers for Lisa Michelle Sugerman-hermansen such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1619287208 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103TC0700X | Psychologist - Clinical | 6278375-2501 (Utah) | Secondary |
103G00000X | Clinical Neuropsychologist | 6278375-2501 (Utah) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lisa Michelle Sugerman-hermansen is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Lisa Michelle Sugerman-hermansen, PHD 3838 S 700 E Ste 101, Salt Lake City, UT 84106-1494 Ph: (801) 716-4284 | Lisa Michelle Sugerman-hermansen, PHD 3838 S 700 E Ste 101, Salt Lake City, UT 84106-1494 Ph: (801) 716-4284 |
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