DR. MITCHELL R. KOLES PH.D.
NPI 1942365630
Psychologist in Salt Lake City, UT

Active since December 25, 2006Opted out of Medicare · through Oct 1, 2026
505 E 200 S, SUITE 303, SALT LAKE CITY, UT 84102(801) 350-0121(801) 350-9582 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Mitchell R. Koles Ph.d. NPPES

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

DR. MITCHELL R. KOLES PH.D. (NPI 1942365630) is an individual psychologist in Salt Lake City, Utah, licensed in Utah (116938-2501) and active in the NPI registry since December 2006. He has opted out of Medicare through October 1, 2026.

NPPES Registry Identity

NPI1942365630
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. MITCHELL R. KOLESCredential: PH.D.
Location Address505 E 200 S, SUITE 303Salt Lake City, UT 84102-2022
Mailing Address505 E 200 S, Suite 303Salt Lake City, UT 84102-2022 · (801) 350-0121 · Fax (801) 350-9582
Fax(801) 350-9582
Sole ProprietorYes
Enumeration DateDecember 25, 2006
Last NPPES UpdateJuly 9, 2007
NPI 1942365630 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 · 116938-2501
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.
505 E 200 S, Salt Lake City, UT 84102

Other Identifiers 2

Medicare UPINS15951UT
Medicare ID-Type Unspecified7554UT · Psychologist

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Dr. Mitchell R. Koles 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 October 1, 2020 through October 1, 2026.

Opt-Out Effective DateOctober 1, 2020
Opt-Out In Effect ThroughOctober 1, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 10

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

Psychologist
505 E 200 S, STE 303
SALT LAKE CITY, UT 84102
Psychologist (Clinical)
505 E 200 S, SUITE 303
SALT LAKE CITY, UT 84102
Chiropractor
505 E 200 S, SUITE 425
SALT LAKE CITY, UT 84102
Chiropractor
505 E 200 S, SUITE 425
SALT LAKE CITY, UT 84102
Psychologist (Clinical)
505 E 200 S, SUITE 303
SALT LAKE CITY, UT 84102
Psychologist
505 E 200 S, SUITE 303
SALT LAKE CITY, UT 84102
Chiropractor
505 E 200 S, STE 425
SALT LAKE CITY, UT 84102
Psychologist (Clinical)
505 E 200 S, SUITE 303
SALT LAKE CITY, UT 84102

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 Mitchell Koles's NPI number?

The NPI number for Mitchell Koles is 1942365630. It was assigned to this individual provider in the NPPES registry on December 25, 2006.

Where is Mitchell Koles located?

Mitchell Koles practices at 505 E 200 S Suite 303, Salt Lake City, UT 84102. The listed phone number is (801) 350-0121.

What is Mitchell Koles's specialty?

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

Is Mitchell Koles enrolled in Medicare?

No. Mitchell Koles has opted out of Medicare through October 1, 2026. 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 Mitchell Koles was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.