NPIMap

Organization Active NPI

Life-Span Psychological Services, LLC

  • Professional Counselor
  • Brookfield, WI
National Provider Identifier
1366615205
Registry record updated Jul 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3073-125 Issued in WI
Legal business name
LIFE-SPAN PSYCHOLOGICAL SERVICES, LLC
Practice address
13035 W Bluemound Rd Ste 100
Brookfield, WI 53005-8001
Phone
(262) 784-1121
Fax
(262) 784-9777
NPI assigned
Apr 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2009

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

Authorized official

Name
Dr. Thomas Scot Lehmann, PH.D.NPI 1558426999
Title
Owner
Phone
(262) 784-1121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 3073-125 WI Primary

Addresses

Primary practice location

13035 W Bluemound Rd Ste 100
Brookfield, WI 53005-8001

Mailing address

13035 W Bluemound Rd
Suite #100
Brookfield, WI 53005-8001
Phone (262) 784-1121

Other identifiers 1

IdentifierTypeStateIssuer
43571100MedicaidWI

Other names 1

  • Life-Span Family Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090820000570 WI Part B Supplier - Clinic/Group Practice 5991859258 Receives reassigned benefits from 10 practitioners
Practice locations: Brookfield, WI

National Provider Directory

National Provider Directory

Locations

13035 W Bluemound Rd
Ste 1
Brookfield, WI 53005

13035 W Bluemound Rd
Ste 100
Brookfield, WI 53005
Phone (262) 223-6125

448 S Military Rd
Ste A
Fond du Lac, WI 54935

W177N9886 Rivercrest Dr
Ste 104
Germantown, WI 53022
Phone (262) 784-1121

384 W Sumner St
Hartford, WI 53027
Phone (262) 223-6125

2266 N Prospect Ave
Ste 503
Milwaukee, WI 53202
Phone (262) 784-1121

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247097600000",
    "number": "1366615205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13035 W BLUEMOUND RD",
            "address_2": "SUITE #100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530058001",
            "telephone_number": "262-784-1121",
            "fax_number": "414-425-5113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13035 W BLUEMOUND RD STE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530058001",
            "telephone_number": "262-784-1121",
            "fax_number": "262-784-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE-SPAN PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-11",
        "last_updated": "2009-07-09",
        "status": "A",
        "authorized_official_last_name": "LEHMANN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "SCOT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-784-1121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3073-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43571100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life-Span Family Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2009; 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.