Organization
LIFESTANCE HEALTH - WYOMING, LLC DBA LIFESTANCE HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN PARDO (CHIEF LEGAL OFFICER)
(425) 279-8500
Entity
Organization
Contact information
Practice address
2232 DELL RANGE BLVD STE 318, CHEYENNE, WY 82009-4902
(253) 346-0399
Mailing address
4800 N SCOTTSDALE RD STE 2500, SCOTTSDALE, AZ 85251-7630
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
05/20/2026
Last updated
05/20/2026
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