DR. MITCHELL WAYNE HARRIS (PHD) – Psychologist, NPI 1053619585

Psychologist

DR. MITCHELL WAYNE HARRIS (PHD) is a healthcare provider. based in Salt lake city, Utah. specializing in Psychologist. They hold the professional credentials PHD. They hold a License No. 9187581-2501 (UT). The NPI Number for DR. MITCHELL WAYNE HARRIS (PHD) is 1053619585

Main info

Male

15 Years Of Experience

Accepts Medicare Assignment

Name

DR. MITCHELL WAYNE HARRIS (PHD)

NPI

1053619585

Phone

(888) 949-4864

Address

5965 S 900 E

Enumeration Date

8 March 2011

Last Update Date

13 December 2018

Doctor Profile

Medical School Name

OTHER

Secondary Phone

8013734760

Graduation Year

2011 (15 years ago)

PAC ID

0941549364

Group Practice PAC ID

2567367915

Professional Enrollment ID

I20190301002031

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience54

Completeness75

Years active:15State licenses:1Digital endpointsOther names

Provider Addresses for DR. MITCHELL WAYNE HARRIS (PHD)

5965 S 900 E
SALT LAKE CITY, UT 841211720
Phone: (888) 949-4864
Type: Location
750 N FREEDOM BLVD
PROVO, UT 846011677
Phone: (801) 373-4760
Fax: (801) 373-0639
Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

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Medicare Enrollment & Revalidation

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

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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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 84121)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 2567367915View full group profile

Name	Specialty	State
DALLAS BEAN	-	UT
MRS. KAREN DEE AMSDEN (LCSW)	-	UT
MARLENE SISSON (LCSW)	Clinical Social Worker	UT
MARY JEAN RIDGES (LCSW)	Clinical Social Worker	UT
CLINT W PETERSON (APRN)	-	UT
CONNIE LYNN WINN	-	UT
BRET JOHN LINTON (BS, MSW, LCSW)	-	UT
TRAVIS J HUNTER (APRN-INTERN)	Nurse Practitioner	UT
MS. LISA JANE OLSEN (APRN)	-	UT
KEVIN HARMON	Clinical Social Worker	UT