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Organization

LIFESTANCE HEALTH - NORTH DAKOTA, PC 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
3523 45TH ST S STE 100, FARGO, ND 58104-8962
(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
103TC0700X
Clinical Psychologist
103TC1900X
Counseling Psychologist
104100000X
Social Worker
1041C0700X
Clinical Social Worker
106H00000X
Marriage & Family Therapist
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
Primary
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Enumeration date
05/28/2026
Last updated
05/28/2026
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