THE LIFE CHANGE CENTER (NPI# 1073978151) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073978151 |
| Entity Type | Organization |
| Organization Name | THE LIFE CHANGE CENTER |
| Practice Address |
1201 N Stewart St Ste 120 Carson City NV 89706-3004 |
| Mailing Address |
1755 Sullivan Ln Sparks NV 89431-2815 |
| Practice Telephone | 7753507250 |
| Practice Fax Number | 7754613570 |
| Mailing Telephone | 7754995534 |
| Mailing Fax Number | 7754995535 |
| Enumeration Date | 2015-12-16 |
| Last Update Date | 2015-12-16 |
| Authorized Official Name | DR. RYAN ZELLER (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 7754995534 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
8312NTC-0 | NV | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922056415 | The Life Change Center | Psychologist | 130 Vine St, Reno, NV 89503-5546 | 2006-05-05 |
| 1205389129 | The Life Change Center | Psychologist | 1755 Sullivan Ln, Sparks, NV 89431-2815 | 2016-07-27 |
| 1841743762 | The Life Change Center | Psychologist | 1201 N Stewart St Ste 120, Carson City, NV 89706-3004 | 2016-07-27 |
| Street Address |
1201 N STEWART ST STE 120 |
| City | CARSON CITY |
| State | NV |
| Zip Code | 89706-3004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083995963 | Ruth Ellen Fox | Registered Nurse | 1201 N Stewart St Ste 120, Carson City, NV 89706-3004 | 2011-09-06 |
| 1356963144 | Jeanine Serusa | Counselor | 1201 N Stewart St Ste 120, Carson City, NV 89706-3004 | 2020-05-14 |
| 1295269611 | Cheyenne Fletcher | Registered Nurse | 1201 N Stewart St Ste 120, Carson City, NV 89706-3004 | 2017-04-12 |
| 1841743762 | The Life Change Center | Psychologist | 1201 N Stewart St Ste 120, Carson City, NV 89706-3004 | 2016-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144795741 | Vera Whole Health, Wa PC | Clinic/Center | 190 E. Winnie Lane, Carson City, NV 89706 | 2018-10-10 |
| 1811339013 | Eng Keong Tan | Internal Medicine | 2874 N Carson St Ste 120, Carson City, NV 89706 | 2013-07-29 |
| 1649583691 | Tamara June Nance | Marriage & Family Therapist | 1047 Mark Way, Carson City, NV 89706 | 2010-07-20 |
| 1992926646 | Jack Richard Araza | Psychologist | 309 East John St. Ste #1, Carson City, NV 89706 | 2007-05-01 |
| 1003939356 | Kenneth Anthony Edwards | Psychologist | 10116 Highway 50 East, Suite 101, Mound House, NV 89706 | 2007-04-09 |
| 1528132065 | Raymond B Graber II | Dentist | 2600 E College Parkway H23, Carson City, NV 89706 | 2006-11-17 |
| 1619511268 | Lindsey Michele Benedict | Pharmacist | 3325 Research Way, Community Health Pharmacy, Carson City, NV 89706 | 2019-11-06 |
| 1598279648 | Michelle Rae Tye | Behavior Technician | 3416 Goni Rd Ste D132, Carson City, NV 89706 | 2017-11-28 |
| 1952720203 | Nalini Channapatna Prasanna | Social Worker | 1665 Old Hot Springs Road, Suite 150, Carson City, NV 89706 | 2014-04-15 |
| 1851646657 | Farres Nitam Uddin Ahmed | Radiology | 2874 N Carson St Ste 300, Carson City, NV 89706 | 2012-07-17 |
| Find all providers in zip 89706 | ||||
| Taxonomy Code | 103TA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841743762 | The Life Change Center | Psychologist | 1201 N Stewart St Ste 120, Carson City, NV 89706-3004 | 2016-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447850144 | Mental Edge Therapy Professional LLC | Psychologist | 2520 St. Rose Parkway, Suite 220-a (219), Las Vegas, NV 89120 | 2020-10-30 |
| 1124650015 | Alexandra Wilcox | Psychologist | 322 Wintercress Dr, Henderson, NV 89002-5137 | 2020-02-07 |
| 1972011492 | On A Cloud Therapy | Psychologist | 848 N Rainbow Blvd # 4818, Las Vegas, NV 89107-1103 | 2018-01-18 |
| 1669904876 | Rachael Sand | Psychologist | 12251 Avalon Canyon Ct, Las Vegas, NV 89138-4621 | 2017-03-28 |
| 1235674425 | Bobby Vavla, LLC | Psychologist | 8987 W Flamingo Rd Ste 105, Las Vegas, NV 89147-0437 | 2016-12-27 |
| 1194011270 | Joanne Krumpe | Psychologist | 507 W. 6th St, Reno, NV 89503 | 2011-06-27 |
| 1477791713 | Sharon L. Steele | Psychologist | 979 Melba Dr, Reno, NV 89503-2730 | 2009-01-24 |
| 1295993863 | Jeffrey Christopher Wood | Psychologist | 555 California Ave, Boulder City, NV 89005-2757 | 2008-05-29 |
| 1356470108 | Glenda Lee Allen | Psychologist | 835 Rock Blvd, Sparks, NV 89431 | 2007-03-05 |
| 1922056415 | The Life Change Center | Psychologist | 130 Vine St, Reno, NV 89503-5546 | 2006-05-05 |
| Find all providers with the same taxonomy | ||||
| City | CARSON CITY |
| Zip Code | 89706 |
Please comment or provide details below to improve the information on THE LIFE CHANGE CENTER.
| 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.