NPIMap

Organization Active NPI

Lansing Institute of Behavioral Medicine, PLLC

  • Psychiatry Physician
  • Lansing, MI
National Provider Identifier
1386954907
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
LANSING INSTITUTE OF BEHAVIORAL MEDICINE, PLLC
Practice address
3475 Belle Chase Way
Lansing, MI 48911-4252
Phone
(517) 882-3732
Fax
(517) 882-3633
NPI assigned
Oct 16, 2010
Last updated
Dec 9, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Authorized official

Name
Kristina Dorrene Conrad
Title
Credentialing Coordinator
Phone
(517) 882-3732

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

3475 Belle Chase Way
Lansing, MI 48911-4252

Mailing address

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

Other practice location 1

7062 9 Mile Rd Ste B
Mecosta, MI 49332-9376
Phone (517) 882-3732

Other practice location 2

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

Other names 1

  • Lifestance Health, Inc Other name

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

7554 Solutions Ctr
Chicago, IL 60677

301 State St
Ste 6
Harbor Beach, MI 48441
Phone (989) 479-0200

4095 Legacy Pkwy
Ste 400
Lansing, MI 48911

7062 9 Mile Rd
Ste B
Mecosta, MI 49332

NPI Registry JSON

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

{
    "created_epoch": "1287187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639008000000",
    "number": "1386954907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3475 BELLE CHASE WAY",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114252",
            "telephone_number": "517-882-3732",
            "fax_number": "517-882-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 BELLE CHASE WAY",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114252",
            "telephone_number": "517-882-3732",
            "fax_number": "517-882-3633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7062 9 Mile Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Mecosta",
            "state": "MI",
            "postal_code": "493329376",
            "country_code": "US",
            "telephone_number": "517-882-3732",
            "fax_number": "517-882-3633",
            "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"
        }
    ],
    "basic": {
        "organization_name": "LANSING INSTITUTE OF BEHAVIORAL MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-16",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A",
        "authorized_official_last_name": "CONRAD",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_middle_name": "DORRENE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "517-882-3732"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifestance Health, Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; 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.