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MOUNT LOGAN CLINIC LLC
NPI 1275152910
Counselor - Mental Health in Logan, UT

Active since April 13, 2020
246 E 1260 N, LOGAN, UT 84341(435) 750-6300(435) 753-8995 Get Directions Write a Review

NPPES record last updated: July 29, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 29, 2021, Apr 13, 2020 (2 updates tracked since 2020).

About Mount Logan Clinic Llc NPPES

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

MOUNT LOGAN CLINIC LLC (NPI 1275152910) is a healthcare organization registered as a mental health in Logan, Utah and active in the NPI registry since April 2020. The organization lists Kyle Hancock, Owner/provider, as its authorized official.

NPPES Registry Identity

NPI1275152910
Entity TypeOrganization
Primary Taxonomy101YM0800X
Legal Business NameMOUNT LOGAN CLINIC LLC
Location Address246 E 1260 NLogan, UT 84341-7501
Mailing Address246 E 1260 NLogan, UT 84341-7501 · (435) 750-6300 · Fax (435) 753-8995
Phone(435) 750-6300
Fax(435) 753-8995
Organization SubpartNo
Authorized OfficialKyle HancockOwner/provider · (435) 750-6300
Enumeration DateApril 13, 2020
Last NPPES UpdateJuly 29, 20212 updates tracked since enumeration
NPPES CertifiedJuly 29, 2021
✔ NPI 1275152910 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
246 E 1260 N, Logan, UT 84341
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Utah.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mount Logan Clinic Llc 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 Mount Logan Clinic LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kyle Hancock, PHD
Clinical Psychologist
NPI 1164748729
246 E 1260 N
Logan, UT 84341
(435) 750-6300
✔ PECOS✔ Accepts MedicareSame address

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 Mount Logan Clinic LLC's NPI number?

The NPI number for Mount Logan Clinic LLC is 1275152910. It was assigned to this organization in the NPPES registry on April 13, 2020.

Where is Mount Logan Clinic LLC located?

Mount Logan Clinic LLC is located at 246 E 1260 N, Logan, UT 84341. The listed phone number is (435) 750-6300.

What is Mount Logan Clinic LLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Mount Logan Clinic LLC enrolled in Medicare?

Yes. Mount Logan Clinic LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mount Logan Clinic LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Mount Logan Clinic LLC. 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.

What insurance does Mount Logan Clinic LLC accept?

Health plans from BridgeSpan Health Company and Regence BlueCross BlueShield of Utah list Mount Logan Clinic LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mount Logan Clinic LLC was last updated on July 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.