Organization
INTEGRATIVE WELLNESS SOLUTIONS, PLLC
Active
Other names
LifeStance Health
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN PARDO (CHIEF LEGAL OFFICER)
(206) 399-1493
Entity
Organization
Contact information
Practice address
122 GATEWAY BLVD STE C, MOORESVILLE, NC 28117-5544
(704) 360-3637
Mailing address
PO BOX 4962, MOORESVILLE, NC 28117-4962
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
133V00000X
Registered Dietitian
—
—
2084P0800X
Psychiatry Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
10/12/2017
Last updated
05/21/2025
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