National Provider Identifier Database

RICHARD W MICKELSEN, MD – NPI #1740250372
Child & Adolescent Psychiatry

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.


Contact Information

RICHARD W MICKELSEN, MD
1300 E CENTER ST
PROVO, UT84606-3554
Phone: 801-344-4215
Fax: 801-344-4225
Website:
Specialty Taxonomy Code
* Child & Adolescent Psychiatry 2084P0804X
Psychiatry 2084P0800X

* Indicates primary specialty

NPI Profile & details for RICHARD W MICKELSEN

NPI Number 1740250372
Credentials MD
Entity Individual
Enumeration date 01/25/2006
Last updated 02/18/2026 - About 4 months ago
Sole proprietor1 Yes
Identifiers
  • UT License #: 5336032-1205
  • UT Other: U001 BLUE CROSS
  • UT Other: U009 CHAMPUS
  • UT Other: U002 DESERET MUTUAL
  • UT Other: U003 EDUCATORS MUTUAL
  • UT Other: U006 INTERMOUTAIN HEALTH CARE
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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