Healthcare Provider Details

I. General information

NPI: 1346035003
Provider Name (Legal Business Name): ERIK J REINBERGS PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 04/14/2025
Certification Date: 04/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6405 OLD MAIN HILL
LOGAN UT
84322-6405
US

IV. Provider business mailing address

6405 OLD MAIN HILL
LOGAN UT
84322-6405
US

V. Phone/Fax

Practice location:
  • Phone: 435-797-2293
  • Fax:
Mailing address:
  • Phone: 435-797-2293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number14103940-2501
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: