Healthcare Provider Details

I. General information

NPI: 1518807551
Provider Name (Legal Business Name): LONE PEAK PSYCHOLOGICAL EVALUATIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6787 S REDWOOD RD STE 2
WEST JORDAN UT
84084-2404
US

IV. Provider business mailing address

6787 S REDWOOD RD STE 2
WEST JORDAN UT
84084-2404
US

V. Phone/Fax

Practice location:
  • Phone: 801-203-4442
  • Fax:
Mailing address:
  • Phone: 801-203-4442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: CASEY MANGNALL
Title or Position: EXECUTIVE DIRECTOR
Credential: PSYD
Phone: 801-203-4442