EMMA MANSOUR (PHD) – Psychologist, NPI 1043611486

EMMA MANSOUR (PHD) is a healthcare provider. based in Farmington, Utah. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 8781073-2501 (UT). The NPI Number for EMMA MANSOUR (PHD) is 1043611486

Main info

Female
Sole Proprietor
13 Years Of Experience
Accepts Medicare Assignment
Name
EMMA MANSOUR (PHD)
NPI
1043611486
Phone
(801) 232-1161
Address
1170 SHEPARD CRK PKWY
Enumeration Date
4 September 2014
Last Update Date
5 June 2025

Doctor Profile

Medical School Name
UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Secondary Phone
3852194980
Graduation Year
2013 (13 years ago)
PAC ID
3072733047
Professional Enrollment ID
I20140926000341
Address ID
UT840252746FA1433XWXXX401
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:11State licenses:1Digital endpointsOther names

236 CLINICAL PSYCHOLOGIST in UT

Provider Addresses for EMMA MANSOUR (PHD)

  • 1170 SHEPARD CRK PKWY

    FARMINGTON, UT 840252851

    Phone: (801) 232-1161

    Type: Mailing

  • 1433 N 1075 W STE 120

    FARMINGTON, UT 840252746

    Phone: (385) 219-4980

    Type: Location

  • 525 E 100 S

    102

    SALT LAKE CITY, UT 841024210

    Phone: (801) 483-2447

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-09-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140926000341IClinical PsychologistUTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84025)

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Reviews

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Frequently asked questions

Does EMMA MANSOUR (PHD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — EMMA MANSOUR (PHD) uses 1043611486.
Is EMMA MANSOUR (PHD) listed as active for patients and plans?
The listing shows EMMA MANSOUR (PHD) as active in the NPI system.
What is EMMA MANSOUR (PHD)'s primary classification?
Psychologist is the headline specialty for EMMA MANSOUR (PHD) here. Clinical services aligned with this taxonomy classification.
What address line appears for EMMA MANSOUR (PHD)?
EMMA MANSOUR (PHD)'s geographic hint is Farmington, Utah in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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