Provider Demographics
NPI:1073387650
Name:A BALANCED MIND
Entity Type:Organization
Organization Name:A BALANCED MIND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BRITTANI
Authorized Official - Middle Name:F
Authorized Official - Last Name:MUNCHEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMHC
Authorized Official - Phone:863-370-8051
Mailing Address - Street 1:4404 S FLORIDA AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2183
Mailing Address - Country:US
Mailing Address - Phone:863-370-8051
Mailing Address - Fax:
Practice Address - Street 1:4404 S FLORIDA AVE STE 2
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2183
Practice Address - Country:US
Practice Address - Phone:863-370-8051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A BALANCED MIND, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty