AGING CLINIC OF SOUTHERN UTAH PLLC
NPI 1043091960
Psychologist in Cedar City, UT

Active since October 06, 2023
94 S 300 E, CEDAR CITY, UT 84720(435) 277-0285 Get Directions Write a Review

NPPES record last updated: February 20, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Aging Clinic Of Southern Utah Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AGING CLINIC OF SOUTHERN UTAH PLLC (NPI 1043091960) is a healthcare organization registered as a psychologist in Cedar City, Utah and active in the NPI registry since October 2023. The organization lists Kirsten Leigh Graham, Owner/provider, as its authorized official.

NPPES Registry Identity

NPI1043091960
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NameAGING CLINIC OF SOUTHERN UTAH PLLC
Location Address94 S 300 ECedar City, UT 84720-3318
Mailing Address94 S 300 ECedar City, UT 84720-3318 · (435) 277-0285
Organization SubpartNo
Authorized OfficialKirsten Leigh GrahamOwner/provider · (435) 277-0285
Enumeration DateOctober 6, 2023
Last NPPES UpdateFebruary 20, 2024
NPPES CertifiedFebruary 20, 2024
✔ NPI 1043091960 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
94 S 300 E, Cedar City, UT 84720

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Aging Clinic Of Southern Utah Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Aging Clinic Of Southern Utah PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Clinical Psychologist
NPI 1376165530
351 W UNIVERSITY BLVDGENERAL CLASSROOMS 308-O GENERAL CLASSROOMS 308-O
Cedar City, UT 84720
(435) 277-0285
✔ PECOS✔ Accepts Medicare0.4 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Aging Clinic Of Southern Utah PLLC's NPI number?

The NPI number for Aging Clinic Of Southern Utah PLLC is 1043091960. It was assigned to this organization in the NPPES registry on October 6, 2023.

Where is Aging Clinic Of Southern Utah PLLC located?

Aging Clinic Of Southern Utah PLLC is located at 94 S 300 E, Cedar City, UT 84720. The listed phone number is (435) 277-0285.

What is Aging Clinic Of Southern Utah PLLC's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Aging Clinic Of Southern Utah PLLC enrolled in Medicare?

Yes. Aging Clinic Of Southern Utah PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Aging Clinic Of Southern Utah PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Aging Clinic Of Southern Utah PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Aging Clinic Of Southern Utah PLLC was last updated on February 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.