DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: LIFESTANCE HEALTH - MISSISSIPPI, LLC DBA LIFESTANCE HEALTH

MEDICARE: LIFESTANCE HEALTH - MISSISSIPPI, LLC DBA LIFESTANCE HEALTH
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
1101YM0800XMental Health Counselor
2103T00000XPsychologist
31041C0700XClinical Social Worker
4106H00000XMarriage & Family Therapist
52084A0401XAddiction Medicine (Psychiatry & Neurology) Physician
62084P0802XAddiction Psychiatry Physician
7363LP0808XPsychiatric/Mental Health Nurse Practitioner
8101Y00000XCounselor
92084B0040XBehavioral Neurology & Neuropsychiatry Physician

General Provider Information

NPI Number : 1700717550
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFESTANCE HEALTH - MISSISSIPPI, LLC DBA LIFESTANCE HEALTH
Provider Business Mailing Address
First Line : 4800 N SCOTTSDALE RD STE 2500
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-7630
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 232 MARKET ST
Second Line :
City : FLOWOOD
State : MS
Zip : 39232-3339
Country : US
Telephone Number : 253-346-0399
Fax Number :
Authorized Official
Title or Position : CHIEF LEGAL OFFICER
Name : RYAN PARDO
Credential :
Telephone Number : 425-279-8500
Provider Enumeration Date : 05/28/2026
Last Update Date : 05/28/2026

Similar Medicare Providers

1659051621 — BREANNA SHENK NP
Practice Location Address:
232 MARKET ST
FLOWOOD, MS
39232-3339
Practice Phone: 866-849-0692
Practice Fax:
1992323059 — AVERI BROOKELYN SMITH BOTTS FNP-C
Practice Location Address:
232 MARKET ST
FLOWOOD, MS
39232-3339
Practice Phone: 866-849-0692
Practice Fax:
1265104095 — KIMBERLY SHAW FNP
Practice Location Address:
232 MARKET ST
FLOWOOD, MS
39232-3339
Practice Phone: 866-849-0692
Practice Fax:
1639105794 — DR. GREGORY ANDREW GORDON M.D.
Practice Location Address:
232 MARKET ST , SUITE 234
FLOWOOD, MS
39232-3339
Practice Phone: 601-214-3539
Practice Fax: 601-914-7201
1407991086 — ROCKY HOLMES FNP
Practice Location Address:
232 MARKET ST
FLOWOOD, MS
39232-3339
Practice Phone: 337-991-9276
Practice Fax: 337-943-0846
1780976183 — VANESSA BELLAMY LPC, NCC
Practice Location Address:
232 MARKET ST
FLOWOOD, MS
39232-3339
Practice Phone: 601-500-1194
Practice Fax:

Directions to “LIFESTANCE HEALTH - MISSISSIPPI, LLC DBA LIFESTANCE HEALTH ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.