Provider Demographics
NPI:1215410980
Name:BALCH, BRITANY (MA, LMFT)
Entity Type:Individual
Prefix:MISS
First Name:BRITANY
Middle Name:
Last Name:BALCH
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 LOMBARD ST APT 209
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-5251
Mailing Address - Country:US
Mailing Address - Phone:772-240-2973
Mailing Address - Fax:
Practice Address - Street 1:1035 S SEMORAN BLVD STE 2-1047
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-5526
Practice Address - Country:US
Practice Address - Phone:321-401-7026
Practice Address - Fax:321-401-7026
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-10
Last Update Date:2023-08-25
Deactivation Date:2023-07-21
Deactivation Code:
Reactivation Date:2023-08-24
Provider Licenses
StateLicense IDTaxonomies
106S00000X
FLMT4707101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician