Lifestance Health

LBN: Psychology Specialists Ltd
Lifestance Health is an health care organization with primary practice located at 808 S Eldorado Rd Ste 102 , Bloomington IL 61704-6075. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is the primary health care specialty. Psychology Specialists Ltd can be contacted via phone (888) 428-7890, or through Russo, Adam via phone (888) 428-7890.

Contact Information

Primary practice address
808 S Eldorado Rd Ste 102 Bloomington IL 61704-6075
Phone: (888) 428-7890
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Russo, Adam
Phone: (888) 428-7890

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 180-005747 Illinois
Behavioral Health & Social Service Providers / Counselor 101Y00000X 180-005332 Illinois
Behavioral Health & Social Service Providers / Clinical 103TC0700X 071-005708 Illinois
Behavioral Health & Social Service Providers / Clinical 103TC0700X 071-006198 Illinois
Behavioral Health & Social Service Providers / Clinical 103TC0700X 071-006980 Illinois
Behavioral Health & Social Service Providers / Clinical 1041C0700X 149011166 Illinois

Profile Details

NPI number 1053368605
LBN Legal business name Psychology Specialists Ltd
DBA Doing business as Lifestance Health
Authorized official Russo, Adam
Entity Organization
Organization subpart 1 No
Enumeration date May 28th, 2006
Last updated Sep 26th, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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