| Lifestance Health | |
|
1105 Sw 30th Ct Moore OK 73160 | |
| (405) 378-2727 | |
| Not Available |
| Full Name | Lifestance Health |
|---|---|
| Speciality | Psychologist |
| Location | 1105 Sw 30th Ct, Moore, Oklahoma |
| Authorized Official Name and Position | Ryan Pardo (CHIEF LEGAL OFFICER) |
| Authorized Official Contact | 2063991493 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifestance Health 1105 Sw 30th Ct Moore OK 73160 Ph: () - | Lifestance Health 1105 Sw 30th Ct Moore OK 73160 Ph: (405) 378-2727 |
| NPI Number | 1790186385 |
|---|---|
| Provider Enumeration Date | 09/15/2014 |
| Last Update Date | 03/28/2023 |
| Certification Date | 03/28/2023 |
| Medicare PECOS PAC ID | 3476927740 |
|---|---|
| Medicare Enrollment ID | O20230328002277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790186385 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 27766 (Oklahoma) | Primary |
| Provider Name | Bradley A Mcclure |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790755916 PECOS PAC ID: 2365478104 Enrollment ID: I20050823000045 |
| Provider Name | Lisa A Seabridge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316969157 PECOS PAC ID: 1456476050 Enrollment ID: I20100920001094 |
| Provider Name | Angela Workman Dickson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578690004 PECOS PAC ID: 2365609468 Enrollment ID: I20120201000295 |
| Provider Name | Luci Ann Gratch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104102961 PECOS PAC ID: 0547424145 Enrollment ID: I20120612000107 |
| Provider Name | Rebecca Cline |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366720229 PECOS PAC ID: 1951566793 Enrollment ID: I20120629000292 |
| Provider Name | Heath H Mueller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972731750 PECOS PAC ID: 0345497863 Enrollment ID: I20120905000555 |
| Provider Name | Sandra Mace |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700114295 PECOS PAC ID: 5496062093 Enrollment ID: I20150915001211 |
| Provider Name | Neil Anthony Weathers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356989883 PECOS PAC ID: 5597195164 Enrollment ID: I20200422001567 |
| Provider Name | Rachael Aline Touma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598398133 PECOS PAC ID: 4789015009 Enrollment ID: I20200520001725 |
| Provider Name | Mallory Jaymes Hanson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902372311 PECOS PAC ID: 5294143004 Enrollment ID: I20210415002280 |
| Provider Name | Ellisa Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215401708 PECOS PAC ID: 2365834124 Enrollment ID: I20220128000377 |
| Provider Name | Brenda Kay Richards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316590714 PECOS PAC ID: 5991162455 Enrollment ID: I20230530000473 |
| Provider Name | Carrie M. Mcdowell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194207472 PECOS PAC ID: 1759740962 Enrollment ID: I20230706002565 |
| Provider Name | Karen Schaaf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295704484 PECOS PAC ID: 8628099561 Enrollment ID: I20230804000282 |
| Provider Name | Jared Nile Seth Keck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396453197 PECOS PAC ID: 6901269190 Enrollment ID: I20230906001973 |
| Provider Name | Colby Pacheco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912603077 PECOS PAC ID: 8123474822 Enrollment ID: I20231101002572 |
| Provider Name | Karin Price |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700354420 PECOS PAC ID: 3971951039 Enrollment ID: I20231129003505 |
| Provider Name | Katelyn Alison Kern |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487916987 PECOS PAC ID: 3072962208 Enrollment ID: I20231213000048 |
| Provider Name | Natalie G Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801512157 PECOS PAC ID: 2860835071 Enrollment ID: I20240205002688 |
| Provider Name | Amber Hulgan |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1184946410 PECOS PAC ID: 2365887437 Enrollment ID: I20240228002241 |
| Provider Name | Aleshia M Overall |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477833788 PECOS PAC ID: 3870938764 Enrollment ID: I20240301001447 |
| Provider Name | Brittany M Foshee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164963625 PECOS PAC ID: 5496190118 Enrollment ID: I20240304001595 |
| Provider Name | Henriatta A Collins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710244561 PECOS PAC ID: 1153766803 Enrollment ID: I20240304002647 |
| Provider Name | Holley Michelle Elam |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629583620 PECOS PAC ID: 7517302201 Enrollment ID: I20240304003890 |
| Provider Name | Kevin Foley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952859415 PECOS PAC ID: 9638515786 Enrollment ID: I20240311003676 |
| Provider Name | Cherri Ledbetter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114232782 PECOS PAC ID: 0042656167 Enrollment ID: I20240312002022 |
| Provider Name | Collyn Deshae Campbell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497912745 PECOS PAC ID: 1355787250 Enrollment ID: I20240314000827 |
| Provider Name | John Levi Stanford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881286995 PECOS PAC ID: 6103262936 Enrollment ID: I20240314002465 |
| Provider Name | Sheila J Self |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053558379 PECOS PAC ID: 4183060965 Enrollment ID: I20240314004363 |
| Provider Name | Melissa Lynne Thorman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831421783 PECOS PAC ID: 6800232687 Enrollment ID: I20240315000029 |
The Therapy Group Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2119 Riverwalk Dr # 173, Moore, OK 73160 Phone: 405-596-0885 | |
Pathwork Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 624 Nw 5th St, Moore, OK 73160 Phone: 240-727-9677 | |
Hope-joy-peace Counseling Services Plc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 N Broadway St, Suite 109, Moore, OK 73160 Phone: 405-831-7791 Fax: 405-759-2944 | |
Cindy L. Parson Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4201 Mackenzie Dr, Moore, OK 73160 Phone: 405-570-9564 Fax: 405-759-3321 | |
Kayla Wright Counseling, P.l.l.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1901 N Moore Ave Ste 15, Moore, OK 73160 Phone: 405-277-0482 | |
Moore Alcohol And Drug Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 624 Nw 5th St, Moore, OK 73160 Phone: 405-799-3379 Fax: 405-799-0912 | |
Hip-enterprizes Ltd Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 505 Ne 12th St, Moore, OK 73160 Phone: 405-447-6188 Fax: 405-735-5265 |