NPIMap

Organization Active NPI

Life Strategy Center

  • Clinical Psychologist
  • Sheridan, WY
National Provider Identifier
1770718033
Registry record updated Apr 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
403 Issued in WY
Legal business name
LIFE STRATEGY CENTER
Practice address
1949 Sugarland Dr
Suite 218
Sheridan, WY 82801-5755
Phone
(307) 674-8686
Fax
(307) 674-1825
NPI assigned
May 15, 2009
Last updated
Apr 22, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2015

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

Authorized official

Name
Mr. Charles D Shipley, LPCNPI 1568693455
Title
Co-Owner/Counselor
Phone
(307) 674-8686

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 424 WY
Professional Counselor 101YP2500X 552 WY
Clinical Psychologist 103TC0700X 403 WY Primary

Addresses

Primary practice location

1949 Sugarland Dr
Suite 218
Sheridan, WY 82801-5755

Mailing address

PO Box 7035
Sheridan, WY 82801-7001
Phone (307) 674-8686

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150410001971 WY Part B Supplier - Clinic/Group Practice 2860710472 Receives reassigned benefits from 2 practitioners
Practice locations: Sheridan, WY

National Provider Directory

National Provider Directory
Tax ID family
Life Strategy Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1242345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429660800000",
    "number": "1770718033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7035",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828017001",
            "telephone_number": "307-674-8686",
            "fax_number": "307-674-1825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1949 SUGARLAND DR",
            "address_2": "SUITE 218",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828015755",
            "telephone_number": "307-674-8686",
            "fax_number": "307-674-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE STRATEGY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-15",
        "last_updated": "2015-04-22",
        "status": "A",
        "authorized_official_last_name": "SHIPLEY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CO-OWNER/COUNSELOR",
        "authorized_official_telephone_number": "307-674-8686",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WY",
            "license": "424",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WY",
            "license": "552",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WY",
            "license": "403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheridan, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; 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.