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LIFESPAN BEHAVIORAL HEALTH LLC NPI 1033229281


NPI Information

NPI: 1033229281
Provider Name: LIFESPAN BEHAVIORAL HEALTH, LLC

Former Legal Business Name: INDIVIDUAL AND FAMILY PSYCHOLOGICAL SERVICES, LLC

Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
1745 S ALMA SCHOOL RD
172
MESA, AZ
ZIP 85210
Phone: (602) 324-4676
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LIFESPAN BEHAVIORAL HEALTH, LLC is a clinical psychologist in Mesa, AZ. The provider is 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. LIFESPAN BEHAVIORAL HEALTH, LLC NPI is 1033229281. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Individual And Family Psychological Services, Llc.

The provider's business location address is:

1745 S ALMA SCHOOL RD
172
MESA, AZ
ZIP 85210-009
Phone: (602) 324-4676
Fax: (480) 209-1063

The provider's authorized official is Ronald Colby Miller .
The authorized official title is Psychologist/owner and has the following contact phone number (602) 622-3021.

The enumeration date for this NPI number is 8/30/2006 and was last updated on 4/23/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC0700XPsychologistClinical3676ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1944654MEDICAIDARIZONA
2944654OTHERARIZONAEVERCARE
3944654OTHERARIZONAMERCY CARE
4372456OTHERARIZONAMHN
5Z103616MEDICARE ID-TYPE UNSPECIFIEDARIZONA
6DE2993MEDICARE ID-TYPE UNSPECIFIEDARIZONARAILROAD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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