Organization Active NPI

Restore Lyfe LLC

  • Intellectual & Developmental Disabilities Psychologist
  • Stafford, VA
National Provider Identifier
1740002369
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
Legal business name
RESTORE LYFE LLC
Practice address
22 Chadwick Dr
Stafford, VA 22556-4622
Phone
(571) 501-7151
NPI assigned
Oct 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Authorized official

Name
Mrs. Hannah Karen England, MASTERSNPI 1174385488
Title
Owner
Phone
(520) 709-9163

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual & Developmental Disabilities PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TM1800X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

22 Chadwick Dr
Stafford, VA 22556-4622

Mailing address

22 Chadwick Dr
Stafford, VA 22556-4622
Phone (571) 501-7151

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1729814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729814400000",
    "number": "1740002369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 CHADWICK DR",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225564622",
            "telephone_number": "571-501-7151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 CHADWICK DR",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225564622",
            "telephone_number": "571-501-7151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE LYFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-25",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A",
        "authorized_official_last_name": "ENGLAND",
        "authorized_official_first_name": "HANNAH",
        "authorized_official_middle_name": "KAREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-709-9163",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MASTERS"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.