Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1881098051 Individual Practitioner Male Practitioner

Augusto Gancinia , AGENCY AFFILIATED RE

Psychologist • Provo, UT

Professional Overview & Biography Verified Profile Summary

Augusto Gancinia, AGENCY AFFILIATED RE is a registered healthcare professional specializing in Psychologist in Provo, UT. Practice services are available at 455 N UNIVERSITY AVE STE 201 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

455 N University Ave Ste 201

Provo, UT 846012867

Telephone 3854462466
Associated Practice Facility / Clinic
🏢 Canyon Ridge Psychology Llc Facility NPI 1841022795

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Provo, UT

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 22.0 Yrs
State Avg: 17.8 Yrs
Regional Practice Density
39 Specialists

Practicing in Provo, UT (447 Statewide)

Telehealth Adoption Rate
7.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-01-28
Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License UT 12458199-2501

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1265230759

Licensed Psychologist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location January 28, 2026

Registered at 455 N UNIVERSITY AVE STE 201, PROVO, UT 846012867 (Tel: 3854462466)

📍
Updated Business Mailing Address January 28, 2026

Registered at 455 N UNIVERSITY AVE STE 201, PROVO, UT 846012867 (Tel: 3854462466)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 28, 2026

Psychologist (License #12458199-2501 in UT)

NPI Profile Active October 29, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location October 29, 2014

Registered at 340 NE MAPLE, PULLMAN, WA 99163 (Tel: 5093341133)

📍
Updated Business Mailing Address October 29, 2014

Registered at 340 NE MAPLE, PULLMAN, WA 99163 (Tel: 5093341133)

👤
Provider Name / Credentials Updated October 29, 2014

Recorded as AUGUSTO GANCINIA, AGENCY AFFILIATED RE

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 29, 2014

Counselor (License #GC60503995 in WA)

🟢
Initial NPI Registration & Enumeration October 17, 2014

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1881098051
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 17, 2014
Last Update: January 28, 2026
Sole Proprietor: Yes

Mailing Address

455 N University Ave Ste 201

Provo, UT 846012867

Phone: 3854462466

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.