Active NPI
Lifestance Health - New Mexico, LLC Dba Lifestance Health LLC
- Behavioral Neurology & Neuropsychiatry Physician
- Albuquerque, NM
National Provider Identifier
1407787294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavioral Neurology & Neuropsychiatry Physician
- Legal business name
- LIFESTANCE HEALTH - NEW MEXICO, LLC DBA LIFESTANCE HEALTH LLC
- Practice address
- 100 Sun Ave NE Ste 650
Albuquerque, NM 87109-4670 - Phone
- (253) 346-0399
- NPI assigned
- May 28, 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 10
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X | |||
| Psychologist | 103T00000X | |||
| Counseling Psychologist | 103TC1900X | |||
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | |||
| Marriage & Family Therapist | 106H00000X | |||
| Addiction Medicine (Psychiatry & Neurology) Physician | 2084A0401X | |||
| Behavioral Neurology & Neuropsychiatry Physician | 2084B0040X | Primary |
Addresses
Primary practice location
100 Sun Ave NE Ste 650
Albuquerque, NM 87109-4670
Mailing address
4800 N Scottsdale Rd Ste 2500
Scottsdale, AZ 85251-7630
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1779926400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788998400000",
"number": "1407787294",
"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": "100 SUN AVE NE STE 650",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871094670",
"telephone_number": "253-346-0399"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFESTANCE HEALTH - NEW MEXICO, LLC DBA LIFESTANCE HEALTH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-05-28",
"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": "103TC1900X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Counseling",
"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": "106H00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"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
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Albuquerque, NM
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.