MEDICARE: LIFESTYLE MENTAL HEALTH, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1831030147
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFESTYLE MENTAL HEALTH, PLLC

Provider Business Mailing Address
First Line	:	333 W 2230 N STE 225
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84604-6709
Country	:	US
Telephone Number	:	385-230-7799
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 W 2230 N STE 225
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84604-6709
Country	:	US
Telephone Number	:	385-230-7799
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ALEX MAGENO
Credential	:	MD
Telephone Number	:	385-230-7799

Provider Enumeration Date	:	04/02/2026
Last Update Date	:	04/02/2026

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