Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Lifestance Health - Idaho, PC Dba Lifestance Health

Organization Counselor · NPI 1407787336

Lifestance Health - Idaho, PC Dba Lifestance Health provides Counselor services in Boise, Idaho. Registered with an NPI since 2026.

In the registry since
2026
Specialties on file
9
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

950 W Bannock St Ste 1100
Boise, ID 83702-6140
Phone: (208) 723-1397
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavioral Neurology & Neuropsychiatry Physician (primary) Taxonomy 2084B0040X
Counselor Taxonomy 101Y00000X
Mental Health Counselor Taxonomy 101YM0800X
Psychologist Taxonomy 103T00000X
Social Worker Taxonomy 104100000X
Clinical Social Worker Taxonomy 1041C0700X
Marriage & Family Therapist Taxonomy 106H00000X
Addiction Medicine (Psychiatry & Neurology) Physician Taxonomy 2084A0401X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X

Record details

NPI number1407787336
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ryan Pardo — Chief Legal Officer · (206) 399-1493
NPI enumeratedMay 28, 2026
Last updated in NPPESSeptember 25, 2026
Certification dateSeptember 24, 2026
Mailing address4800 N Scottsdale Rd Ste 2500, Scottsdale, AZ 85251-7630

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