LIFE-SPAN PSYCHOLOGICAL SERVICES LLC NPI 1366615205

NPI Information

NPI: 1366615205
Provider Name: LIFE-SPAN PSYCHOLOGICAL SERVICES, LLC

Doing Business As: LIFE-SPAN FAMILY SERVICES

Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
13035 W BLUEMOUND RD STE 100
BROOKFIELD, WI
ZIP 53005
Phone: (262) 784-1121
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LIFE-SPAN PSYCHOLOGICAL SERVICES, LLC is a professional counselor in Brookfield, WI. LIFE-SPAN PSYCHOLOGICAL SERVICES, LLC NPI is 1366615205. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Life-span Family Services.

The provider's business location address is:

13035 W BLUEMOUND RD STE 100
BROOKFIELD, WI
ZIP 53005-001
Phone: (262) 784-1121
Fax: (262) 784-9777

The provider's authorized official is Thomas Scot Lehmann .
The authorized official title is Owner and has the following contact phone number (262) 784-1121.

The enumeration date for this NPI number is 4/11/2008 and was last updated on 7/9/2009.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	3073-125	WISCONSIN	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	43571100	MEDICAID	WISCONSIN

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

NPI Synchronization or Removal

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