LIFESPAN BEHAVIORAL HEALTH, LLC (NPI# 1033229281) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033229281 |
| Entity Type | Organization |
| Organization Name | LIFESPAN BEHAVIORAL HEALTH, LLC |
| Other Organization Name | INDIVIDUAL AND FAMILY PSYCHOLOGICAL SERVICES, LLC |
| Practice Address |
1745 S Alma School Rd 172 Mesa AZ 85210-3009 |
| Practice Telephone | 6023244676 |
| Practice Fax Number | 4802091063 |
| Mailing Telephone | 6023244676 |
| Mailing Fax Number | 4802091063 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2009-04-23 |
| Authorized Official Name | RONALD COLBY MILLER (PSYCHOLOGIST/OWNER) |
| Authorized Official Telephone | 6026223021 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
3676 | AZ | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | MHN | 372456 | 01 |
| AZ | EVERCARE | 944654 | 01 |
| AZ | MERCY CARE | 944654 | 01 |
| AZ | 944654 | 05 |
| Other Name | Type Code |
|---|---|
| Individual and Family Psychological Services, LLC | Former Legal Business Name - Organization |
| Street Address |
1745 S ALMA SCHOOL RD 172 |
| City | MESA |
| State | AZ |
| Zip Code | 85210-3009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700491404 | Abbie Ashton | Marriage & Family Therapist | 1745 S Alma School Rd, Mesa, AZ 85210-3009 | 2020-09-10 |
| 1033724992 | Jennifer Susan Ohlund | Counselor | 1745 S Alma School Rd, Mesa, AZ 85210-3009 | 2020-09-08 |
| 1174181648 | Thomas J Olsen | Counselor | 1745 S Alma School Rd, Mesa, AZ 85210-3009 | 2019-05-30 |
| 1043727241 | Alexia Meghan Coppell | Specialist/Technologist | 1745 S Alma School Rd, Mesa, AZ 85210-3009 | 2018-01-09 |
| 1720507510 | Laura Lyon | Specialist/Technologist | 1745 S Alma School Rd, Mesa, AZ 85210-3009 | 2017-09-13 |
| 1497273080 | Whitney Jo Wilhelmi | Occupational Therapist | 1745 S Alma School Rd, Mesa, AZ 85210-3009 | 2017-09-02 |
| 1043759566 | Michelle Tucker | Occupational Therapist | 1745 S Alma School Rd, Suite 145, Mesa, AZ 85210-3009 | 2017-02-16 |
| 1417490491 | Julie Young | Counselor | 1745 S Alma School Rd, Mesa, AZ 85210-3009 | 2016-11-23 |
| 1871942763 | Cara Roberts | Speech-Language Pathologist | 1745 S Alma School Rd, 145, Mesa, AZ 85210-3009 | 2016-06-10 |
| 1225495971 | Alyssa Rekart | Specialist/Technologist | 1745 S Alma School Rd, 145, Mesa, AZ 85210-3009 | 2016-01-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497382501 | Mesa Center for Family Medicine | Internal Medicine | 2034 S Alma School Road, Suite #101, Mesa, AZ 85210 | 2020-03-26 |
| 1780177121 | Jessica Cannata | Speech-Language Pathologist | 2150 S Country Club Rd, Suite 20, Mesa, AZ 85210 | 2018-06-11 |
| 1831680305 | Alexandra Katherine Ebong | Nurse Practitioner | 1950 S. Country Club Drive, Ste 102, Mesa, AZ 85210 | 2018-05-21 |
| 1548762719 | Russell D. Meldrum, M.d. Pllc | Orthopaedic Surgery | 855 W. Southern Ave., #1114, Mesa, AZ 85210 | 2018-03-05 |
| 1023510435 | Denise M Bruno-krupp | Counselor | 1830 S. Alma School Rd. Suite 101, Mesa, AZ 85210 | 2018-03-01 |
| 1609374529 | Gene R Lullo | Social Worker | 1830 S Alma School Rd Suite 101, Mesa, AZ 85210 | 2018-01-25 |
| 1295264000 | Ashley P Smith | Naturopath | 601 S Alma School Rd, Apt 101, Mesa, AZ 85210 | 2017-06-06 |
| 1386184059 | Brittany Johnson | Counselor | 1745 S Alma School Rd Ste 230, Mesa, AZ 85210 | 2017-03-01 |
| 1487190880 | Mesa Valley Modern Dentistry, LLP | Dentist | 1712 S, Country Club Drive, Ste 104, Mesa, AZ 85210 | 2017-01-10 |
| 1821544529 | Sandra Coren | Licensed Practical Nurse | 32 S Mcdonald, Tlc, Mesa, AZ 85210 | 2016-09-01 |
| Find all providers in zip 85210 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518501980 | Jennifer Jones, Psy.d., LLC | Psychologist | 1930 S Alma School Rd Ste D106, Mesa, AZ 85210-3095 | 2019-10-29 |
| 1568989671 | Heal Az Counseling and Wellness Center Pllc | Psychologist | 1845 S Dobson Rd Ste 109, Mesa, AZ 85202-5662 | 2017-08-29 |
| 1417327735 | Jessica Leclerc - Oasis Psychological Services, Pllc | Psychologist | 1930 S Alma School Rd. Ste. A216, Mesa, AZ 85210 | 2015-09-29 |
| 1598194813 | Laura Mann | Psychologist | 122 N Country Club Dr, Mesa, AZ 85201-6522 | 2013-11-06 |
| 1821363730 | Steven G Fox Phd PC | Psychologist | 1845 S Dobson Rd Ste 106, Mesa, AZ 85202-5661 | 2012-03-12 |
| 1730480856 | Beverly Costantini | Psychologist | 2500 South Power Road, Bldg 9, Ste 223, Mesa, AZ 85209-6690 | 2010-11-04 |
| 1326295510 | Marilyn Stromsness | Psychologist | 2228 E Jaeger St, Mesa, AZ 85213-2933 | 2008-08-19 |
| 1891993143 | Shelly K. Woodward | Psychologist | 1845s Dobson Rd 207, Mesa, AZ 85202-5663 | 2007-07-09 |
| 1144439852 | Julio F. Angulo | Psychologist | 3039 E Irwin Ave, Mesa, AZ 85204-7271 | 2007-05-21 |
| 1982811170 | Nancy Elaine Yeamans | Psychologist | 2210 W Southern Ave, Suite B-5, Mesa, AZ 85202-4714 | 2007-05-17 |
| Find all providers in MESA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.