Lifespan Behavioral Health Nevada PC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

LIFESPAN BEHAVIORAL HEALTH NEVADA PC

Practice address

2401 W Horizon Ridge Pkwy Ste 110
Henderson, NV 89052-2707

Phone

(702) 544-1776

NPI assigned

Apr 23, 2020

Organization subpart

No

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

Authorized official

Name

Carolyn Reidy

Title

Office Admin

Phone

(800) 819-7570

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Derek Joseph Chamberlain, LCMHC

  • Mental Health Counselor
  • Henderson, NV
  • NPI 1841564978
  Medicare reassignment Care Compare group NPD
• Shanna O'Connor

  • Professional Counselor
  • Las Vegas, NV
  • NPI 1508377565
  Medicare reassignment Care Compare group NPD
• John Dahunsi, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Olney, MD
  • NPI 1386378735

  NV

  Medicare reassignment Care Compare group NPD
• Joshua Sussal, MD

  • Psychiatry Physician
  • Greenbelt, MD
  • NPI 1922212174

  NV

  Medicare reassignment Care Compare group
• Amy Zawatsky

  • Professional Counselor
  • Greenbelt, MD
  • NPI 1316284755

  NV

  Medicare reassignment NPD
• Katie Henkel, PA-C

  • Medical Physician Assistant
  • Milford, MI
  • NPI 1326582875

  NV

  Medicare reassignment

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744070400000",
    "number": "1114547726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 ANTHEM VILLAGE DR STE E-508",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W HORIZON RIDGE PKWY STE 110",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522707",
            "telephone_number": "702-544-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPAN BEHAVIORAL HEALTH NEVADA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-23",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A",
        "authorized_official_last_name": "REIDY",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "OFFICE ADMIN",
        "authorized_official_telephone_number": "800-819-7570"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Life Improvement Medical Supply LLC
• Lifeclinic Chiropractic of Nevada LLC
• Lifeclinic Chiropractic of Nevada LLC
• Lifes Challenges a Mental Health Consultant Firm
• Lifeskills Therapy LLC
• Lifespan Behavioral Health Nevada PC
• Lifestyle Overhaul, LLC
• Lifetime Body and Health Awareness Haynes Physical Therapy
• Lifetime Body and Health Awareness Physical Therapy PLLC
• Lifetime Hospice Care Inc

• Neurology Physician in Henderson, NV
• Providers in Henderson, NV by specialty
• Neurology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.