LIFESPAN PSYCHOLOGY SERVICES, LLC
NPI 1770844433
Psychologist in Tampa, FL

Active since May 30, 2012
4201 BAYSHORE BLVD, UNIT 1603, TAMPA, FL 33611(617) 784-0771 Get Directions Write a Review

NPPES record last updated: May 30, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lifespan Psychology Services, Llc NPPES

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

LIFESPAN PSYCHOLOGY SERVICES, LLC (NPI 1770844433) is a healthcare organization registered as a psychologist in Tampa, Florida and active in the NPI registry since May 2012. The organization lists Athena Boolukos Gordon, President, as its authorized official.

NPPES Registry Identity

NPI1770844433
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NameLIFESPAN PSYCHOLOGY SERVICES, LLC
Location Address4201 BAYSHORE BLVD, UNIT 1603Tampa, FL 33611-1669
Mailing Address4201 Bayshore Blvd, Unit 1603Tampa, FL 33611-1669 · (617) 784-0771
Organization SubpartNo
Authorized OfficialAthena Boolukos GordonPresident · (617) 784-0771
Enumeration DateMay 30, 2012
NPI 1770844433 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
4201 BAYSHORE BLVD, Tampa, FL 33611

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist
4201 BAYSHORE BLVD, UNIT 1603
TAMPA, FL 33611

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 Lifespan Psychology Services, LLC's NPI number?

The NPI number for Lifespan Psychology Services, LLC is 1770844433. It was assigned to this organization in the NPPES registry on May 30, 2012.

Where is Lifespan Psychology Services, LLC located?

Lifespan Psychology Services, LLC is located at 4201 Bayshore Blvd Unit 1603, Tampa, FL 33611. The listed phone number is (617) 784-0771.

What is Lifespan Psychology Services, LLC's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

When was this NPI record last updated?

The NPPES record for Lifespan Psychology Services, LLC was last updated on May 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.