Lifestream Therapy, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

LIFESTREAM THERAPY, LLC

Practice address

10162 E Olla Ave
Mesa, AZ 85212-2378

Phone

(951) 448-7035

NPI assigned

Sep 20, 2023

Last updated

Sep 20, 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

Robert Scott Gminder

Title

Owner

Phone

(951) 448-7035

Specialties & licenses 1

Addresses

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.

• Thomas Ruderstaller, LPC

  • Professional Counselor
  • Tempe, AZ
  • NPI 1043693096

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1695168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1972381846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23520 MARBLEHEAD CIR",
            "city": "CANYON LAKE",
            "state": "CA",
            "postal_code": "925877706",
            "telephone_number": "951-448-7035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10162 E OLLA AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852122378",
            "telephone_number": "951-448-7035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTREAM THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-20",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "GMINDER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-448-7035"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifeline Professional Counseling Services, Inc
• Lifeline Professional Counseling Services, Inc (Lifeline East)
• Lifeoak Mental Health PLLC
• Lifespan Behavioral Health, LLC
• Lifestream Counseling LLC
• Lifestyle Balance Healthcare Trust (Lifestyle Balance Healthcare)
• Lifestyle Health and Wellness
• Lifewell Behavioral Wellness (Lifewell - University)
• Lifewell Behavioral Wellness
• Lifewell Behavioral Wellness

• Mental Health Counselor in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.