Provider Demographics
NPI:1033609961
Name:KAREN BALUCH, LPCC BAKER FAMILY COUNSELING
Entity Type:Organization
Organization Name:KAREN BALUCH, LPCC BAKER FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:BALUCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-488-8646
Mailing Address - Street 1:179 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:CONNEAUT
Mailing Address - State:OH
Mailing Address - Zip Code:44030-2614
Mailing Address - Country:US
Mailing Address - Phone:440-645-1949
Mailing Address - Fax:440-858-2108
Practice Address - Street 1:179 BROAD ST
Practice Address - Street 2:
Practice Address - City:CONNEAUT
Practice Address - State:OH
Practice Address - Zip Code:44030-2614
Practice Address - Country:US
Practice Address - Phone:440-645-1949
Practice Address - Fax:440-858-2108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-16
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE1200421101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0199700Medicaid