Provider Demographics
NPI:1164930459
Name:BALANCE BECOMES YOU L.L.C.
Entity Type:Organization
Organization Name:BALANCE BECOMES YOU L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:BRANDES
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:716-204-6978
Mailing Address - Street 1:10610 HABITAT TRL
Mailing Address - Street 2:
Mailing Address - City:BOKEELIA
Mailing Address - State:FL
Mailing Address - Zip Code:33922-3109
Mailing Address - Country:US
Mailing Address - Phone:716-204-6978
Mailing Address - Fax:
Practice Address - Street 1:13960 STRINGFELLOW RD
Practice Address - Street 2:
Practice Address - City:BOKEELIA
Practice Address - State:FL
Practice Address - Zip Code:33922-2312
Practice Address - Country:US
Practice Address - Phone:716-204-6978
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15687101YM0800X
NY007832-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty