| Ascendant Behavioral Health Dba Lifestance | |
|
5965 S 900 E Ste 100 Murray UT 84121-1850 | |
| (801) 872-5516 | |
| (480) 888-9679 |
| Full Name | Ascendant Behavioral Health Dba Lifestance |
|---|---|
| Speciality | Social Worker |
| Location | 5965 S 900 E Ste 100, Murray, Utah |
| Authorized Official Name and Position | Ryan Pardo (CHIEF LEGAL OFFICER) |
| Authorized Official Contact | 4252798500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ascendant Behavioral Health Dba Lifestance Po Box 671298 Dallas TX 75267-1298 Ph: (801) 872-5516 | Ascendant Behavioral Health Dba Lifestance 5965 S 900 E Ste 100 Murray UT 84121-1850 Ph: (801) 872-5516 |
| NPI Number | 1689128605 |
|---|---|
| Provider Enumeration Date | 08/08/2016 |
| Last Update Date | 10/03/2023 |
| Certification Date | 10/03/2023 |
| Medicare PECOS PAC ID | 1850673187 |
|---|---|
| Medicare Enrollment ID | O20170123001085 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689128605 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 2662563501 (Utah) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| Provider Name | Gail C Hilton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033354857 PECOS PAC ID: 2961300876 Enrollment ID: I20031229000977 |
| Provider Name | Laura C Maw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982661039 PECOS PAC ID: 3971592585 Enrollment ID: I20040510000444 |
| Provider Name | Jeanette P Vasquez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477735504 PECOS PAC ID: 3274580915 Enrollment ID: I20050405000371 |
| Provider Name | Mitzy D Stewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538147418 PECOS PAC ID: 4385683416 Enrollment ID: I20050428000457 |
| Provider Name | Katharine Roth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942483854 PECOS PAC ID: 3476617465 Enrollment ID: I20090206000193 |
| Provider Name | Sajid Faizi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659386357 PECOS PAC ID: 8224185756 Enrollment ID: I20090420000492 |
| Provider Name | Jesse R Beebe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760401525 PECOS PAC ID: 6406971423 Enrollment ID: I20100915000005 |
| Provider Name | Regan Haight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356679641 PECOS PAC ID: 0042474660 Enrollment ID: I20120612000251 |
| Provider Name | Wendy K Francis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316103138 PECOS PAC ID: 3678719499 Enrollment ID: I20130424000598 |
| Provider Name | Lorrie M Belnap |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093006348 PECOS PAC ID: 8820306228 Enrollment ID: I20151005002664 |
| Provider Name | Laurie Elkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003129586 PECOS PAC ID: 7416223763 Enrollment ID: I20171101000764 |
| Provider Name | Kristen Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205288628 PECOS PAC ID: 8820355753 Enrollment ID: I20171201001730 |
| Provider Name | Heather Dangerfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124504915 PECOS PAC ID: 7315367703 Enrollment ID: I20201023002758 |
| Provider Name | Lin Clark |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1770044570 PECOS PAC ID: 5698189587 Enrollment ID: I20210204002372 |
| Provider Name | William Andrew Russell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871079335 PECOS PAC ID: 4587041587 Enrollment ID: I20220512002186 |
| Provider Name | Jamie C Mathews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710318738 PECOS PAC ID: 3870972367 Enrollment ID: I20220613002320 |
| Provider Name | Candas Marie Elder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053960732 PECOS PAC ID: 1658741137 Enrollment ID: I20221227001028 |
| Provider Name | Lindsey Hulet Van Roo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225695877 PECOS PAC ID: 9537517693 Enrollment ID: I20231129003386 |
| Provider Name | Melissa Joy Blumell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952791741 PECOS PAC ID: 6901258318 Enrollment ID: I20240122003699 |
| Provider Name | Brahm Alexander Gordon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659558658 PECOS PAC ID: 6608228952 Enrollment ID: I20240123000631 |
| Provider Name | Alisha Kay Schlabaugh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316510357 PECOS PAC ID: 6901258276 Enrollment ID: I20240123001223 |
| Provider Name | Pedro Leonardo Perez Aquino |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1588214811 PECOS PAC ID: 7810340916 Enrollment ID: I20240124004786 |
| Provider Name | Sabrena Ness |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083100218 PECOS PAC ID: 7618320714 Enrollment ID: I20240124004866 |
| Provider Name | Stephanie Hunt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154624021 PECOS PAC ID: 1759734783 Enrollment ID: I20240125004746 |
| Provider Name | Colin Wilford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306442181 PECOS PAC ID: 0840633756 Enrollment ID: I20240207004048 |
| Provider Name | Christina Alicia Calderon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386685998 PECOS PAC ID: 9537315312 Enrollment ID: I20240215003079 |
| Provider Name | Gayle Scanlan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326770595 PECOS PAC ID: 5092182667 Enrollment ID: I20240226000303 |
| Provider Name | Jeffrey Dennis David |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659967123 PECOS PAC ID: 1052752243 Enrollment ID: I20240520000944 |
| Provider Name | Heather Christine Jenkins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912328576 PECOS PAC ID: 0840632071 Enrollment ID: I20240520002856 |
| Provider Name | Roger Norman Durfey |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1336276534 PECOS PAC ID: 4082056890 Enrollment ID: I20240524001754 |
| Provider Name | Ariella M Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699027516 PECOS PAC ID: 5890137574 Enrollment ID: I20240527000370 |
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