The Life Change Center

Primary specialty

Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X

License

8312NTC-0 Issued in NV

Legal business name

THE LIFE CHANGE CENTER

Practice address

1201 N Stewart St Ste 120
Carson City, NV 89706-3004

Phone

(775) 350-7250

Fax

(775) 461-3570

NPI assigned

Dec 16, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Ryan Zeller, D.O.

Title

Medical Director

Phone

(775) 499-5534

Specialties & licenses 3

Addresses

Tax ID family

The Life Change Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• The Life Change Center

  • Addiction (Substance Use Disorder) Psychologist
  • Sparks, NV
  • NPI 1205389129
  NPD tax ID
• The Life Change Center

  • Addiction (Substance Use Disorder) Psychologist
  • Carson City, NV
  • NPI 1841743762
  NPD tax ID
• The Life Change Center

  • Addiction (Substance Use Disorder) Psychologist
  • Reno, NV
  • NPI 1922056415
  NPD tax ID

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

{
    "created_epoch": "1450224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1073978151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 SULLIVAN LN",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894312815",
            "telephone_number": "775-499-5534",
            "fax_number": "775-499-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N STEWART ST STE 120",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897063004",
            "telephone_number": "775-350-7250",
            "fax_number": "775-461-3570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE LIFE CHANGE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-16",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A",
        "authorized_official_last_name": "ZELLER",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "775-499-5534",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "8312NTC-0",
            "primary": true
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Tenner, MPH, RDN, CDCES
• Roy Terry
• Elle Teruya
• The Healing Space
• The Health Lab, LLC
• The Life Change Center
• The Mindful Goldfish LLC
• The Nevada Center
• Theresa Simmons
• Thi of Nevada at Carson LLC

• Addiction (Substance Use Disorder) Psychologist in Carson City, NV
• Providers in Carson City, NV by specialty
• Addiction (Substance Use Disorder) Psychologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.