Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Derra Gullickson, MA, PSYD

Individual provider Clinical Psychologist · NPI 1255851333

Derra Gullickson, MA, PSYD is a Clinical Psychologist in Provo, Utah. Works from 2 locations. Licensed in Utah.

Licensed in
UT
In the registry since
2017
What do these letters mean?
MA — Master of Arts
A graduate arts degree.
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

750 N Freedom Blvd
Provo, UT 84601-1677
Phone: (801) 373-4760
Fax: (801) 373-0639
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 705 N Freedom Blvd., Provo, UT 84601 — (612) 910-6371

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 10979353-2501 (UT)

Record details

NPI number1255851333
Entity typeIndividual (Type 1)
GenderFemale
Credentials MA , PSYD
Sole proprietorNo
NPI enumeratedJune 21, 2017
Last updated in NPPESOctober 31, 2019

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