National Provider Identifier Database

LIFESPAN BEHAVIORAL HEALTH LLC
Clinical

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth — one that is broadly inclusive of severe psychopathology — and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.


Contact Information

LIFESPAN BEHAVIORAL HEALTH, LLC
1745 S ALMA SCHOOL RD
172
MESA, AZ85210-3009
Phone: 602-324-4676
Fax: 480-209-1063
Website:
Specialty Taxonomy Code
* Clinical 103TC0700X

* Indicates primary specialty

NPI Profile & details for LIFESPAN BEHAVIORAL HEALTH, LLC

NPI Number 1033229281
Legal business name
LBN
LIFESPAN BEHAVIORAL HEALTH, LLC
Authorized official RONALD MILLER - (PSYCHOLOGIST/OWNER)
Entity Organization
Organization subpart No
Enumeration date 08/30/2006
Last updated 04/23/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers
  • AZ License #: 3676
  • AZ Medicaid: 944654
  • AZ Other: 944654 EVERCARE
  • AZ Other: 944654 MERCY CARE
  • AZ Other: 372456 MHN

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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