NPIMap

Organization Active NPI

Psychology Specialists LTD

Doing business as LifeStance Health

  • Clinical Psychologist
  • Las Vegas, NV
National Provider Identifier
1003473448
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
PSYCHOLOGY SPECIALISTS LTD
Doing business as
LifeStance Health
Practice address
801 S Rancho Dr Ste A2
Las Vegas, NV 89106-3870
Phone
(702) 805-5360
Fax
(309) 663-2995
NPI assigned
May 21, 2019
Last updated
Jan 25, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
PSYCHOLOGY SPECIALISTS LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Melanie Gray
Title
Billing Specialists
Phone
(253) 527-1571

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X Primary

Addresses

Primary practice location

801 S Rancho Dr Ste A2
Las Vegas, NV 89106-3870

Mailing address

PO Box 8204
Pasadena, CA 91109-8204

Other identifiers 1

IdentifierTypeStateIssuer
PY0777OtherNVLICENSE

Other names 1

  • LifeStance Health Doing business as

National Provider Directory

National Provider Directory
Part of
Psychology Specialists LTD

Locations

2406 E Empire St
Fl 4
Bloomington, IL 61704

1801 W Windsor Rd
#2167
Champaign, IL 61822

250 W Kenwood Ave
Decatur, IL 62526
Phone (217) 872-3800

2200 Fort Jesse Rd
Ste 240
Normal, IL 61761
Phone (309) 268-9300

113 N Parkway Dr
Pekin, IL 61554

5901 N Prospect Rd
Ste 201A
Peoria, IL 61614
Phone (309) 648-0782

2500 W Reynolds St
#209
Pontiac, IL 61764

1108 N Allen St
Ste B
Robinson, IL 62454

Practitioners & affiliated clinicians

Practitioners 98

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 98

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1003473448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8204",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911098204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S RANCHO DR STE A2",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891063870",
            "telephone_number": "702-805-5360",
            "fax_number": "309-663-2995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGY SPECIALISTS LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PSYCHOLOGY SPECIALISTS LTD",
        "enumeration_date": "2019-05-21",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "BILLING SPECIALISTS",
        "authorized_official_telephone_number": "253-527-1571"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PY0777",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeStance Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.