Life Change Associates, PC
NPI 1598077562 · Psychiatry Physician · Pocatello, ID
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Life Change Associates, PC is a Psychiatry Physician organization in Pocatello, ID (NPI 1598077562).
Provider details
- NPI number
- 1598077562
- Entity type
- Organization
- Primary specialty
- Psychiatry PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Deric Ravsten, Owner(208) 233-5433
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Mental Health Counselor101YM0800X
Behavioral Health & Social Service Providers
- Physician Assistant363A00000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2010-07-07
- Last updated
- 2013-11-23
Frequently asked questions
- What is Life Change Associates, PC's NPI number?
- Life Change Associates, PC's National Provider Identifier (NPI) is 1598077562, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Life Change Associates, PC?
- Life Change Associates, PC is classified in the NPPES registry as Psychiatry Physician (Allopathic & Osteopathic Physicians).
- Where is Life Change Associates, PC located?
- Life Change Associates, PC's practice location on file with NPPES is 1777 E Clark St, Pocatello, ID 83201-3357.
- What is Life Change Associates, PC's phone number?
- The practice phone number listed in the NPPES registry for Life Change Associates, PC is (208) 233-5433.
- Does Life Change Associates, PC accept Medicare?
- Life Change Associates, PC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Life Change Associates, PC?
- The authorized official listed on Life Change Associates, PC's NPPES record is Deric Ravsten, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Life Change Associates, PC's NPI active?
- Yes — Life Change Associates, PC's NPI (1598077562) is active in the NPPES registry as of the last update on 2013-11-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.