National Provider Identifier Database

ELIZA R GEDGE, PH.D., LP – NPI #1003197658
Clinical

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth — one that is broadly inclusive of severe psychopathology — and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.


Contact Information

ELIZA R GEDGE, PH.D., LP
750 N FREEDOM BLVD
PROVO, UT84601-1677
Phone: 801-373-0639
Fax: 801-373-0639
Website:
Specialty Taxonomy Code
* Clinical 103TC0700X
Clinical 1041C0700X
Counseling 103TC1900X
Student in an Organized Health Care Education/Training Program 390200000X

* Indicates primary specialty

NPI Profile & details for ELIZA R GEDGE

NPI Number 1003197658
Credentials PH.D., LP
Entity Individual
Enumeration date 09/08/2011
Last updated 04/02/2024 - About 2 years ago
Sole proprietor1 No
Identifiers
  • MI License #: 6301014858
  • UT License #: 12966150-2501
  • UT License #: 12966150-25801
  • MI Medicaid: 1883825
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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