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THE LIFE CHANGE CENTER NPI 1841743762


NPI Information

NPI: 1841743762
Provider Name: THE LIFE CHANGE CENTER
Classification: Psychologist - 103TA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

CLIA Number: 29D2102820

Address:
1201 N STEWART ST STE 120
CARSON CITY, NV
ZIP 89706
Phone: (775) 350-7250
Get Directions

THE LIFE CHANGE CENTER is an addiction (substance use disorder) psychologist in Carson City, NV. The provider is a psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior. THE LIFE CHANGE CENTER NPI is 1841743762. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1201 N STEWART ST STE 120
CARSON CITY, NV
ZIP 89706-004
Phone: (775) 350-7250
Fax: (775) 499-5535

The provider's authorized official is John Firestone .
The authorized official title is Executive Director and has the following contact phone number (775) 499-5534.

The CLIA number assigned to this NPI record is 29D2102820 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/27/2016 and was last updated on 10/8/2019.


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
1103TA0400XPsychologistAddiction (Substance Use Disorder)8312NTC-01NEVADAYes

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.