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LIFE CHANGE ASSOCIATES, PC
NPI 1598077562
Psychiatry & Neurology - Psychiatry in Pocatello, ID

Active since July 07, 2010
1777 E CLARK ST, SUITE 330, POCATELLO, ID 83201(208) 233-5433(877) 284-2783 Get Directions Write a Review

NPPES record last updated: November 23, 2013. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Life Change Associates, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFE CHANGE ASSOCIATES, PC (NPI 1598077562) is a healthcare organization registered as a psychiatry in Pocatello, Idaho and active in the NPI registry since July 2010. The organization lists Deric V Ravsten, Owner, as its authorized official.

NPPES Registry Identity

NPI1598077562
Entity TypeOrganization
Primary Taxonomy2084P0800X
Legal Business NameLIFE CHANGE ASSOCIATES, PC
Location Address1777 E CLARK ST, SUITE 330Pocatello, ID 83201-3357
Mailing Address1777 E Clark St, Suite 330Pocatello, ID 83201-3357 · (208) 233-5433 · Fax (877) 284-2783
Phone(208) 233-5433
Fax(877) 284-2783
Organization SubpartNo
Authorized OfficialDeric V RavstenOwner · (208) 233-5433
Enumeration DateJuly 7, 2010
Last NPPES UpdateNovember 23, 2013
✔ NPI 1598077562 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedPhysician AssistantTaxonomy 363A00000X
1777 E CLARK ST, Pocatello, ID 83201
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., University of Utah Health Plans.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Life Change Associates, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Life Change Associates, PC, which bills Medicare for the services they deliver. Of these, 5 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (7)

Natalia Sorensen, NP
Nurse Practitioner
NPI 1841620085
2547 BUTTE ST
Pocatello, ID 83201
(208) 530-1087
✔ PECOS✔ Accepts Medicare1.9 mi
Steven Mckee, LCSW
Clinical Social Worker
NPI 1649520198
265 E CHUBBUCK RD
Chubbuck, ID 83202
(208) 237-1711
✔ PECOS✔ Accepts Medicare4.3 mi
Levi Graves
Nurse Practitioner
NPI 1720863871
415 N 3RD AVE STE B
Pocatello, ID 83201
(208) 646-4165
✔ PECOS✔ Accepts Medicare4.3 mi
Tiffany Bascom, LCPC
Mental Health Counselor
NPI 1487701058
2520 S 5TH AVE
Pocatello, ID 83204
(208) 233-5433
✔ PECOS✔ Accepts Medicare4.5 mi
Karen Donaldson, M.S., R.D., L.D.
Registered Dietitian or Nutrition Professional
NPI 1699705087
845 W CENTER ST # 208
Pocatello, ID 83204
(208) 406-1084
✔ Accepts Medicare5.0 mi
Matthew Torbenson, MD
Psychiatry
NPI 1104455724
395 W COUGAR BLVD STE 601
Provo, UT 84604
(801) 357-7525
✔ PECOS✔ Accepts Medicare187 mi
Deric Ravsten, D.O.
Psychiatry
NPI 1154431542
621 W MADRONE ST STE 330
Roseburg, OR 97470
(541) 672-2691
✔ PECOS✔ Accepts Medicare555 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Life Change Associates, PC's NPI number?

The NPI number for Life Change Associates, PC is 1598077562. It was assigned to this organization in the NPPES registry on July 7, 2010.

Where is Life Change Associates, PC located?

Life Change Associates, PC is located at 1777 E Clark St Suite 330, Pocatello, ID 83201. The listed phone number is (208) 233-5433.

What is Life Change Associates, PC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Life Change Associates, PC enrolled in Medicare?

Yes. Life Change Associates, PC is registered in the Medicare PECOS enrollment system.

What insurance does Life Change Associates, PC accept?

Health plans from Moda Health Plan, Inc. and University of Utah Health Plans list Life Change Associates, PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Life Change Associates, PC was last updated on November 23, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.