Healthcare Provider Details

I. General information

NPI: 1497694111
Provider Name (Legal Business Name): MOUNTAIN STATES PSYCHIATRIC PARTNERS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5475 ADAMS AVE PKWY
OGDEN UT
84405-6905
US

IV. Provider business mailing address

6008 S 2125 E
OGDEN UT
84403-5352
US

V. Phone/Fax

Practice location:
  • Phone: 801-479-2111
  • Fax:
Mailing address:
  • Phone: 541-591-4848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. AUSTIN GOEBEL
Title or Position: MANAGING MEMBER
Credential: DO
Phone: 541-591-4848