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Life Change Associates, PC

Psychiatry Physician in Pocatello, ID · enumerated 2010 · authorized official Deric Ravsten, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1598077562

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Registry record

Entity type Organization (Type 2)
Legal business name Life Change Associates, PC
Practice address 1777 E Clark St, Suite 330, Pocatello, ID, 83201
Phone (208) 233-5433
Fax (877) 284-2783
Enumeration date Jul 7, 2010
Last updated in NPPES Nov 23, 2013

Taxonomy & classification

101YM0800X Mental Health Counselor Behavioral Health & Social Service Providers Secondary
2084P0800X Psychiatry Physician Allopathic & Osteopathic Physicians Primary
363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Secondary

Authorized official

Name Deric Ravsten
Title Owner
Phone (208) 233-5433

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.
What type of organization is Life Change Associates, PC?
Life Change Associates, PC is registered in NPPES as a Psychiatry Physician (its primary provider taxonomy).

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2013-11-23.