| NPI | 1053368605 |
|---|---|
| Doing Business As | LIFESTANCE HEALTH |
| Entity Type | Organization |
| Authorized Contact | ADAM RUSSO VP Of Operations 888-428-7890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-006198) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 180-005747) |
| 101Y00000X Counselor (Licence: IL 180-005332) | |
| 103TC0700X Psychologist, Clinical (Licence: IL 071-005708) | |
| 103TC0700X Psychologist, Clinical (Licence: IL 071-006980) | |
| 1041C0700X Social Worker, Clinical (Licence: IL 149011166) | |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2022-09-26 |