MEDICARE: INTEGRATED PSYCHOLOGICAL SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	363492-2501	UT

General Provider Information

NPI Number	:	1558572271
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATED PSYCHOLOGICAL SERVICES INC

Provider Business Mailing Address
First Line	:	1174 E GRAYSTONE WAY STE 1E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106-2671
Country	:	US
Telephone Number	:	801-518-1352
Fax Number	:

Provider Business Practice Location Address
First Line	:	1174 E GRAYSTONE WAY STE 1E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106-2671
Country	:	US
Telephone Number	:	801-518-1352
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHAEL SHEFFIELD
Credential	:	PH.D.
Telephone Number	:	801-518-1352

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	03/26/2025

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