Active NPI
Lifestance Health - Wyoming, LLC Dba Lifestance Health
- Behavioral Neurology & Neuropsychiatry Physician
- Cheyenne, WY
National Provider Identifier
1306776554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavioral Neurology & Neuropsychiatry Physician
- Legal business name
- LIFESTANCE HEALTH - WYOMING, LLC DBA LIFESTANCE HEALTH
- Practice address
- 2232 Dell Range Blvd Ste 318
Cheyenne, WY 82009-4902 - Phone
- (253) 346-0399
- NPI assigned
- May 20, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ryan Pardo
- Title
- Chief Legal Officer
- Phone
- (206) 399-1493
Specialties & licenses 9
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X | |||
| Psychologist | 103T00000X | |||
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | |||
| Addiction Medicine (Psychiatry & Neurology) Physician | 2084A0401X | |||
| Behavioral Neurology & Neuropsychiatry Physician | 2084B0040X | Primary | ||
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X |
Addresses
Primary practice location
2232 Dell Range Blvd Ste 318
Cheyenne, WY 82009-4902
Mailing address
4800 N Scottsdale Rd Ste 2500
Scottsdale, AZ 85251-7630
National Provider Directory
National Provider DirectoryLocations
2232 Dell Range Blvd
Ste 318
Cheyenne, WY 82009
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1779235200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788998400000",
"number": "1306776554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4800 N SCOTTSDALE RD STE 2500",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852517630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2232 DELL RANGE BLVD STE 318",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820094902",
"telephone_number": "253-346-0399"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFESTANCE HEALTH - WYOMING, LLC DBA LIFESTANCE HEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2026-05-20",
"last_updated": "2026-09-10",
"certification_date": "2026-09-10",
"status": "A",
"authorized_official_last_name": "PARDO",
"authorized_official_first_name": "RYAN",
"authorized_official_title_or_position": "CHIEF LEGAL OFFICER",
"authorized_official_telephone_number": "206-399-1493"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084A0401X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Addiction Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084B0040X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
"state": null,
"license": null,
"primary": true
},
{
"code": "363LP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cheyenne, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.