NPIMap

Organization Active NPI

Downriver Mental Health Clinic PC

Doing business as Lifestance Health, Inc

  • Psychologist
  • Taylor, MI
National Provider Identifier
1295866135
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
DOWNRIVER MENTAL HEALTH CLINIC PC
Doing business as
Lifestance Health, Inc
Practice address
20500 Eureka Rd
Suite 200
Taylor, MI 48180-6394
Phone
(734) 285-8282
Fax
(734) 281-0402
NPI assigned
Mar 9, 2007
Last updated
Jan 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Authorized official

Name
Ryan Pardo
Title
Cheif Legal Officer
Phone
(206) 399-1493

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Mental Health Counselor 101YM0800X NU
Psychologist 103T00000X NU Primary
Clinical Social Worker 1041C0700X NU
Behavioral Neurology & Neuropsychiatry Physician 2084B0040X NU

Addresses

Primary practice location

20500 Eureka Rd
Suite 200
Taylor, MI 48180-6394

Mailing address

20500 Eureka Rd
Suite 200
Taylor, MI 48180-6394
Phone (734) 285-8282

Other practice location 1

7300 Dixie Hwy Ste 1000
Clarkston, MI 48346-5105
Phone (248) 922-2300

Other practice location 2

5958 N Canton Center Rd Ste 900
Canton, MI 48187-2740
Phone (734) 737-1200

Other practice location 3

7600 Grand River Rd Ste 290
Brighton, MI 48114-7340
Phone (810) 220-2787

Other practice location 4

24715 Little Mack Ave Ste 200
Saint Clair Shores, MI 48080-3207
Phone (586) 777-9000

Other practice location 5

4136 Legacy Pkwy
Lansing, MI 48911-4265
Phone (517) 882-3732

Other practice location 6

1400 Abbot Rd Ste 400
East Lansing, MI 48823-1900
Phone (517) 882-3732

Other practice location 7

44725 Grand River Ave Ste 104
Novi, MI 48375-1024
Phone (734) 285-8282

Other practice location 8

29201 Telegraph Rd Ste 550
Southfield, MI 48034-7664
Phone (248) 213-0501

Other practice location 9

3475 Belle Chase Way
Lansing, MI 48911-4252
Phone (517) 882-3732

Other practice location 10

2628 S Milford Rd
Highland, MI 48357-4938
Phone (810) 494-7180

Other practice location 11

2350 Green Rd Ste 160
Ann Arbor, MI 48105-1572
Phone (734) 285-8282

Other practice location 12

2200 Genoa Business Park Dr Ste 100
Brighton, MI 48114-5328
Phone (810) 494-7180

Other practice location 13

1100 Torrey Rd Ste 100
Fenton, MI 48430-3327
Phone (810) 494-7180

Other practice location 14

1701 Lake Lansing Rd Ste 120
Lansing, MI 48912-3798
Phone (810) 494-7180

Other practice location 15

53435 Grand River Ave
New Hudson, MI 48165-8521
Phone (810) 494-7180

Other practice location 16

3950 Sparks Dr SE Ste 103
Grand Rapids, MI 49546-6159
Phone (517) 882-3732

Other practice location 17

650 Trade Centre Way Ste 140
Portage, MI 49002-0411
Phone (517) 882-3732

Other practice location 18

1760 S Telegraph Rd Ste 220
Bloomfield Hills, MI 48302-0182
Phone (734) 285-8282

Other practice location 19

2251 N Squirrel Rd Ste 315-320
Auburn Hills, MI 48326-4600
Phone (517) 882-3732

Other identifiers 1

IdentifierTypeStateIssuer
7509203930OtherMIBCBS SA

Other names 1

  • Lifestance Health, Inc Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040505000533 MI Part B Supplier - Clinic/Group Practice 7911995139 Receives reassigned benefits from 434 practitioners
6 other NPIs on this enrollment
Practice locations: Grand Rapids, MI; Taylor, MI; Southfield, MI; Saint Clair Shores, MI; Portage, MI; Novi, MI; New Hudson, MI; Lansing, MI…

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Advanced Counseling Services11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

2350 Green Rd
Ste 150160
Ann Arbor, MI 48105
Phone (734) 285-8282

2350 Green Rd
Ste 160
Ann Arbor, MI 48105
Phone (315) 771-4657

2251 N Squirrel Rd
Ste 315320
Auburn Hills, MI 48326

2251 N Squirrel Rd
Ste 316
Auburn Hills, MI 48326

1760 S Telegraph Rd
Ste 200
Bloomfield Township, MI 48302

2200 Genoa Business Park Dr
Ste 100
Brighton, MI 48114
Phone (810) 449-7180

1100 Torrey Rd
Ste 100
Fenton, MI 48430
Phone 8104947180106

1701 Lake Lansing Rd
Ste 120
Lansing, MI 48912
Phone 8104947180 ext. 106

4136 Legacy Pkwy
Lansing, MI 48911
Phone (517) 492-0517

53435 Grand River Ave
New Hudson, MI 48165
Phone (517) 492-0517

44725 Grand River Ave
Ste 104
Novi, MI 48375
Phone (248) 846-8345

24715 Little Mack Ave
Ste 200
St Clr Shores, MI 48080
Phone (586) 777-9000

20500 Eureka Rd
Ste 408
Taylor, MI 48180

Practitioners & affiliated clinicians

Practitioners 522

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 522

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736899200000",
    "number": "1295866135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20500 EUREKA RD",
            "address_2": "SUITE 200",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481806394",
            "telephone_number": "734-285-8282",
            "fax_number": "734-281-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20500 EUREKA RD",
            "address_2": "SUITE 200",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481806394",
            "telephone_number": "734-285-8282",
            "fax_number": "734-281-0402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7300 Dixie Hwy Ste 1000",
            "address_purpose": "LOCATION",
            "city": "Clarkston",
            "state": "MI",
            "postal_code": "483465105",
            "country_code": "US",
            "telephone_number": "248-922-2300",
            "fax_number": "248-922-2304",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5958 N Canton Center Rd Ste 900",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "MI",
            "postal_code": "481872740",
            "country_code": "US",
            "telephone_number": "734-737-1200",
            "fax_number": "734-737-1205",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7600 Grand River Rd Ste 290",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MI",
            "postal_code": "481147340",
            "country_code": "US",
            "telephone_number": "810-220-2787",
            "fax_number": "810-220-2834",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24715 Little Mack Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Saint Clair Shores",
            "state": "MI",
            "postal_code": "480803207",
            "country_code": "US",
            "telephone_number": "586-777-9000",
            "fax_number": "586-777-0823",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4136 Legacy Pkwy",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489114265",
            "country_code": "US",
            "telephone_number": "517-882-3732",
            "fax_number": "517-882-3633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 Abbot Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488231900",
            "country_code": "US",
            "telephone_number": "517-882-3732",
            "fax_number": "517-882-3633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44725 Grand River Ave Ste 104",
            "address_purpose": "LOCATION",
            "city": "Novi",
            "state": "MI",
            "postal_code": "483751024",
            "country_code": "US",
            "telephone_number": "734-285-8282",
            "fax_number": "734-281-0402",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "29201 Telegraph Rd Ste 550",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480347664",
            "country_code": "US",
            "telephone_number": "248-213-0501",
            "fax_number": "248-213-0521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3475 Belle Chase Way",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489114252",
            "country_code": "US",
            "telephone_number": "517-882-3732",
            "fax_number": "517-882-3633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2628 S Milford Rd",
            "address_purpose": "LOCATION",
            "city": "Highland",
            "state": "MI",
            "postal_code": "483574938",
            "country_code": "US",
            "telephone_number": "810-494-7180",
            "fax_number": "810-215-1334",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2350 Green Rd Ste 160",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481051572",
            "country_code": "US",
            "telephone_number": "734-285-8282",
            "fax_number": "734-281-0402",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Genoa Business Park Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MI",
            "postal_code": "481145328",
            "country_code": "US",
            "telephone_number": "810-494-7180",
            "fax_number": "810-215-1334",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Torrey Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Fenton",
            "state": "MI",
            "postal_code": "484303327",
            "country_code": "US",
            "telephone_number": "810-494-7180",
            "fax_number": "810-215-1334",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 Lake Lansing Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489123798",
            "country_code": "US",
            "telephone_number": "810-494-7180",
            "fax_number": "810-215-1334",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "53435 Grand River Ave",
            "address_purpose": "LOCATION",
            "city": "New Hudson",
            "state": "MI",
            "postal_code": "481658521",
            "country_code": "US",
            "telephone_number": "810-494-7180",
            "fax_number": "810-215-1334",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3950 Sparks Dr SE Ste 103",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495466159",
            "country_code": "US",
            "telephone_number": "517-882-3732",
            "fax_number": "517-882-3633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "650 Trade Centre Way Ste 140",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "MI",
            "postal_code": "490020411",
            "country_code": "US",
            "telephone_number": "517-882-3732",
            "fax_number": "517-882-3633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1760 S Telegraph Rd Ste 220",
            "address_purpose": "LOCATION",
            "city": "Bloomfield Hills",
            "state": "MI",
            "postal_code": "483020182",
            "country_code": "US",
            "telephone_number": "734-285-8282",
            "fax_number": "734-281-0402",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2251 N Squirrel Rd Ste 315-320",
            "address_purpose": "LOCATION",
            "city": "Auburn Hills",
            "state": "MI",
            "postal_code": "483264600",
            "country_code": "US",
            "telephone_number": "517-882-3732",
            "fax_number": "517-882-3633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DOWNRIVER MENTAL HEALTH CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A",
        "authorized_official_last_name": "PARDO",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "CHEIF LEGAL OFFICER",
        "authorized_official_telephone_number": "206-399-1493"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS SA",
            "identifier": "7509203930",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifestance Health, Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lifestance Health, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Taylor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.