LifeStance Health – Clinical Psychologist, NPI 1912008178
Clinical Psychologist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for LifeStance Health
1448 NW Market St
Seattle, WA 981073743
Phone: (206) 910-9476
Type: Location
12900 NE 180th St Ste 201
Bothell, WA 980115773
Phone: (253) 752-7320
Type: Location
18765 SW Boones Ferry Rd Ste 100
Tualatin, OR 970628607
Phone: (503) 612-1000
Type: Location
2420 S UNION AVE
TACOMA, WA 984051322
Phone: (253) 752-7320
Fax: (480) 888-9679
Type: Location
UHY Crossleys, Station Road, Ballasalla, Malew, Rushen, IM99 6AB, Isle of Man
PORTLAND, OR 972820819
Phone: (503) 233-5405
Fax: (503) 233-2696
Type: Mailing
880, 82nd Drive, Gladstone, Metro, Clackamas County, Oregon, 97027, United States
GLADSTONE, OR 970271803
Phone: (503) 659-5515
Fax: (503) 659-1994
Type: Location
PO BOX 8550
PASADENA, CA 911098550
Phone: (425) 279-8500
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-05-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040505000049 | O | Clinic/Group Practice | OR | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98107)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.