Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lifetime Changes Behavior Services LLC

Organization Case Management Agency · NPI 1578182770

Lifetime Changes Behavior Services LLC is a Case Management Agency in Staten Island, New York. Works from 2 locations. Registered with an NPI since 2020.

In the registry since
2020
Specialties on file
9
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

683 Henderson Ave Ste A
Staten Island, NY 10310-1575
Phone: (929) 256-0231
Fax: (718) 732-2628
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 20 Cowen Pl Fl 1, Staten Island, NY 10303-2012 — (929) 256-0231

Specialties & licences

Early Intervention Provider Agency (primary) Taxonomy 252Y00000X
Case Management Agency Taxonomy 251B00000X
Developmentally Disabled Services Day Training Agency Taxonomy 251C00000X
Community/Behavioral Health Agency Taxonomy 251S00000X
Community Health Clinic/Center Taxonomy 261QC1500X
Developmental Disabilities Clinic/Center Taxonomy 261QD1600X
Mental Health Clinic/Center (Including Community Mental Health Center) Taxonomy 261QM0801X
Adult Mental Health Clinic/Center Taxonomy 261QM0850X
Adolescent and Children Mental Health Clinic/Center Taxonomy 261QM0855X

Record details

NPI number1578182770
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dana Van Dyke — Owner/Program Director · (929) 256-0231
NPI enumeratedApril 9, 2020
Last updated in NPPESMay 25, 2021
Certification dateMay 25, 2021
Mailing address683 Henderson Ave Ste A, Staten Island, NY 10310-1575

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