NPIMap

Organization Active NPI

Psychological & Behavioral Consultants, LLC

Doing business as LifeStance Health

  • Psychiatry Physician
  • Beachwood, OH
National Provider Identifier
1811915713
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PSYCHOLOGICAL & BEHAVIORAL CONSULTANTS, LLC
Doing business as
LifeStance Health
Practice address
25101 Chagrin Blvd Ste 100
Beachwood, OH 44122-5694
Phone
(216) 468-5000
Fax
(216) 456-8128
NPI assigned
Jul 18, 2006
Last updated
Nov 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Authorized official

Name
Mr. Ryan Pardo
Title
Chief Legal Officer
Phone
(425) 279-8500

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Psychologist 103TC0700X
Clinical Social Worker 1041C0700X
Psychiatry Physician 2084P0800X Primary
Clinic/Center 261Q00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

25101 Chagrin Blvd Ste 100
Beachwood, OH 44122-5694

Mailing address

4800 N Scottsdale Rd Ste 2500
Scottsdale, AZ 85251-7630
Phone (216) 468-5000

Other practice location 1

255 Spencer Rd Ste 201
Saint Peters, MO 63376-2576
Phone (636) 939-2550

Other practice location 2

2458 Old Dorsett Rd Ste 110
Maryland Heights, MO 63043-2423
Phone (314) 476-0732

Other practice location 3

851 E 5th St Ste 308
Washington, MO 63090-3130
Phone (636) 432-5000

Other practice location 4

1034 S Brentwood Blvd Ste 1250
Richmond Heights, MO 63117-1263
Phone (636) 969-2551

Other practice location 5

16020 Swingley Ridge Rd Ste 300
Chesterfield, MO 63017-2085
Phone (636) 681-2620

Other practice location 6

425 S Woods Mill Rd Ste 150
Town and Country, MO 63017-9528
Phone (636) 477-6111

Other practice location 7

816 S Kirkwood Rd Ste 105
Saint Louis, MO 63122-6056
Phone (314) 288-3800

Other practice location 8

25101 Chagrin Blvd.
Suite 100
Beachwood, OH 44122-5694
Phone (216) 831-6611

Other names 1

  • LifeStance Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY, MO3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040405000363 OH Part B Supplier - Clinic/Group Practice 0446243760 Receives reassigned benefits from 625 practitioners
Practice locations: Milford, OH; Middlefield, OH; Mentor, OH; Mason, OH; Liberty Township, OH; Independence, OH; Hilliard, OH; Rocky River, OH…
O20160926002081 KY Part B Supplier - Clinic/Group Practice 0446243760 Receives reassigned benefits from 189 practitioners
Practice locations: Frankfort, KY; Louisville, KY; Lexington, KY; Georgetown, KY; Ft Thomas, KY; Ft Mitchell, KY
O20181204002777 MO Part B Supplier - Clinic/Group Practice 0446243760 Receives reassigned benefits from 116 practitioners
Practice locations: Saint Peters, MO; Washington, MO; Town and Country, MO; Saint Charles, MO; Richmond Heights, MO; Lake St Louis, MO; Bridgeton, MO; Kirkwood, MO…

National Provider Directory

National Provider Directory

Locations (25 of 64)

20 N Grand Ave
Ste 15
Fort Thomas, KY 41075
Phone (513) 975-4673

250 Grandview Dr
Ste 575
Ft Mitchell, KY 41017
Phone (317) 292-7108

105 Windsor Path
Ste 6
Georgetown, KY 40324

120 Prosperous Pl
Ste 150
Lexington, KY 40509
Phone (859) 214-7440

120 Prosperous Pl
Ste 201
Lexington, KY 40509
Phone (859) 368-0609

1255 Providence Place Pkwy
Ste 115
Lexington, KY 40511
Phone (859) 214-7440

161 Prosperous Pl
Lexington, KY 40509
Phone (844) 468-5050

100 Executive Park
Ste 100
Louisville, KY 40207
Phone (844) 468-5050

100 Executive Park
Ste 103
Louisville, KY 40207
Phone (502) 552-5068

10300 Champion Farms Dr
Louisville, KY 40241
Phone (502) 313-1687

2550 Eastpoint Pkwy
Louisville, KY 40223
Phone (502) 975-2960

2550 Eastpoint Pkwy
Ste 210
Louisville, KY 40223
Phone (502) 975-2960

5 Linville Dr
Ste 100
Paris, KY 40361
Phone (859) 987-3388

16020 Swingley Ridge Rd
Ste 300
Chesterfield, MO 63017
Phone (636) 681-2620

4500 Stellar Dr
Apt 104
Columbia, MO 65201
Phone (573) 968-2268

2458 Old Dorsett Rd
Ste 110
Maryland Heights, MO 63043
Phone (314) 476-0732

255 Spencer Rd
Ste 101102
Saint Peters, MO 63376

425 S Woods Mill Rd
Ste 150
Town and Country, MO 63017
Phone (314) 269-0335

145 W 46th St
Ashtabula, OH 44004
Phone (440) 998-7541

36701 American Way
Avon, OH 44011

23625 Commerce Park
Ste 100
Beachwood, OH 44122
Phone (844) 439-7976

25101 Chagrin Blvd
Ste 200
Beachwood, OH 44122
Phone (216) 273-8127

2900 Presidential Dr
Beavercreek, OH 45324
Phone (844) 719-1674

2900 Presidential Dr
Ste 100
Beavercreek, OH 45324
Phone (513) 741-3100

6802 W Snowville Rd
Ste B
Brecksville, OH 44141
Phone (440) 260-8528

Practitioners & affiliated clinicians

Practitioners 1,153

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.

View all 1,153

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1811915713",
    "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",
            "telephone_number": "216-468-5000",
            "fax_number": "216-456-8128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25101 CHAGRIN BLVD STE 100",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225694",
            "telephone_number": "216-468-5000",
            "fax_number": "216-456-8128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 Spencer Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Saint Peters",
            "state": "MO",
            "postal_code": "633762576",
            "country_code": "US",
            "telephone_number": "636-939-2550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2458 Old Dorsett Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Maryland Heights",
            "state": "MO",
            "postal_code": "630432423",
            "country_code": "US",
            "telephone_number": "314-476-0732",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "851 E 5th St Ste 308",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "MO",
            "postal_code": "630903130",
            "country_code": "US",
            "telephone_number": "636-432-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1034 S Brentwood Blvd Ste 1250",
            "address_purpose": "LOCATION",
            "city": "Richmond Heights",
            "state": "MO",
            "postal_code": "631171263",
            "country_code": "US",
            "telephone_number": "636-969-2551",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16020 Swingley Ridge Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630172085",
            "country_code": "US",
            "telephone_number": "636-681-2620",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "425 S Woods Mill Rd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Town and Country",
            "state": "MO",
            "postal_code": "630179528",
            "country_code": "US",
            "telephone_number": "636-477-6111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "816 S Kirkwood Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631226056",
            "country_code": "US",
            "telephone_number": "314-288-3800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25101 Chagrin Blvd.",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Beachwood",
            "state": "OH",
            "postal_code": "441225694",
            "country_code": "US",
            "telephone_number": "216-831-6611",
            "fax_number": "216-456-8128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PSYCHOLOGICAL & BEHAVIORAL CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-01",
        "status": "A",
        "authorized_official_last_name": "PARDO",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "CHIEF LEGAL OFFICER",
        "authorized_official_telephone_number": "425-279-8500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeStance Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.