Organization Active NPI

Life Solutions LLC

  • Psychologist
  • Roanoke, VA
National Provider Identifier
1003623976
Registry record updated Dec 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
LIFE SOLUTIONS LLC
Practice address
3959 Electric Rd Ste 107
Roanoke, VA 24018-4562
Phone
(540) 871-5552
NPI assigned
Dec 14, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2024

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

Authorized official

Name
Mr. Peter J Wallace, QMHP-A
Title
Program Manager
Phone
(540) 871-5552

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

3959 Electric Rd Ste 107
Roanoke, VA 24018-4562

Mailing address

5451 North Lakes Drive
Roanoke, VA 24019
Phone (540) 871-5552

National Provider Directory

National Provider Directory

Locations

3959 Electric Rd
Ste 107
Roanoke, VA 24018
Phone (540) 871-5552

NPI Registry JSON

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

{
    "created_epoch": "1734134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734134400000",
    "number": "1003623976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5451 NORTH LAKES DRIVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "24019",
            "telephone_number": "540-871-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 ELECTRIC RD STE 107",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240184562",
            "telephone_number": "540-871-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-14",
        "last_updated": "2024-12-14",
        "certification_date": "2024-12-14",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "540-871-5552",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "QMHP-A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2024; 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.