LISA M MOUNTAIN PH.D.
NPI 1467622696
Psychologist in Salt Lake City, UT

Active since March 04, 2008Opted out of Medicare · through May 20, 2028
1400 FOOTHILL DR, SUITE 24, SALT LAKE CITY, UT 84108(801) 581-0422(801) 581-0764 Get Directions Write a Review

NPPES record last updated: March 4, 2008. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About Lisa M Mountain Ph.d. NPPES

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

LISA M MOUNTAIN PH.D. (NPI 1467622696) is an individual psychologist in Salt Lake City, Utah, licensed in Utah (2797320-2501) and active in the NPI registry since March 2008. She has opted out of Medicare through May 20, 2028.

NPPES Registry Identity

NPI1467622696
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameLISA M MOUNTAINCredential: PH.D.
Location Address1400 FOOTHILL DR, SUITE 24Salt Lake City, UT 84108-2327
Mailing Address1400 Foothill Dr, Suite 24Salt Lake City, UT 84108-2327 · (801) 581-0422 · Fax (801) 581-0764
Fax(801) 581-0764
Sole ProprietorYes
Enumeration DateMarch 4, 2008
✔ NPI 1467622696 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in UT · 2797320-2501
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.
1400 FOOTHILL DR, Salt Lake City, UT 84108

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Lisa M Mountain Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 20, 2026 through May 20, 2028.

Opt-Out Effective DateMay 20, 2026
Opt-Out In Effect ThroughMay 20, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (General Practice)
1400 FOOTHILL DR, SUITE B38
SALT LAKE CITY, UT 84108
Family Medicine
1400 FOOTHILL DR, SUITE 100
SALT LAKE CITY, UT 84108
Social Worker (Clinical)
1400 FOOTHILL DR, #112
SLC, UT 84108
Family Medicine
1400 FOOTHILL DR, #101
SALT LAKE CITY, UT 84108
Social Worker (Clinical)
1400 FOOTHILL DR, SUITE 24
SALT LAKE CITY, UT 84108
Social Worker (Clinical)
1400 FOOTHILL DR, SUITE 24
SALT LAKE CITY, UT 84108
Dentist (Orthodontics and Dentofacial Orthopedics)
1400 FOOTHILL DR, SUITE #240
SLC, UT 84108
Psychologist (Counseling)
1400 FOOTHILL DR
SALT LAKE CITY, UT 84108

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 Lisa Mountain's NPI number?

The NPI number for Lisa Mountain is 1467622696. It was assigned to this individual provider in the NPPES registry on March 4, 2008.

Where is Lisa Mountain located?

Lisa Mountain practices at 1400 Foothill Dr Suite 24, Salt Lake City, UT 84108. The listed phone number is (801) 581-0422.

What is Lisa Mountain's specialty?

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

Is Lisa Mountain enrolled in Medicare?

No. Lisa Mountain has opted out of Medicare through May 20, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Lisa Mountain was last updated on March 4, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.