Life Changes Mental Health Services PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

LIFE CHANGES MENTAL HEALTH SERVICES PLLC

Practice address

816 Main Street
Lewiston, ID 83501-1870

Phone

(208) 791-6183

Fax

(949) 404-8139

NPI assigned

Jun 5, 2019

Last updated

Apr 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elizabeth L Von Bargen, NPNPI 1336571942

Title

Nurse Practitioner, Owner

Phone

(208) 791-6183

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 1

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.

• Elizabeth L Von Bargen, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lewiston, ID
  • NPI 1336571942
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680825600000",
    "number": "1659939536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 472",
            "city": "CRAIGMONT",
            "state": "ID",
            "postal_code": "835230472",
            "telephone_number": "208-791-6183",
            "fax_number": "949-404-8139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 MAIN STREET",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835011870",
            "telephone_number": "208-791-6183",
            "fax_number": "949-404-8139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CHANGES MENTAL HEALTH SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-05",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A",
        "authorized_official_last_name": "VON BARGEN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "NURSE PRACTITIONER, OWNER",
        "authorized_official_telephone_number": "208-791-6183",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Psychiatric/Mental Health Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2023; 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.