Healthcare Provider Details

I. General information

NPI: 1215215181
Provider Name (Legal Business Name): STEINMANN INSTITUTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2011
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 S 700 E STE 101
SALT LAKE CITY UT
84106-1494
US

IV. Provider business mailing address

3838 S 700 E STE 101
SALT LAKE CITY UT
84106-1494
US

V. Phone/Fax

Practice location:
  • Phone: 801-716-4284
  • Fax: 801-433-0691
Mailing address:
  • Phone: 801-716-4284
  • Fax: 801-433-0691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number6278375-2501
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number7821510-1205
License Number StateUT

VIII. Authorized Official

Name: DR. LISA MICHELLE SUGERMAN-HERMANSEN
Title or Position: OWNER/ NEUROPSYCHOLOGIST
Credential: PHD
Phone: 801-716-4284