Provider Demographics
NPI:1235580002
Name:BALANCED BEING COUNSELING, LLC
Entity Type:Organization
Organization Name:BALANCED BEING COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALISA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FULVIO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-231-3359
Mailing Address - Street 1:1134 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-1673
Mailing Address - Country:US
Mailing Address - Phone:203-231-3359
Mailing Address - Fax:
Practice Address - Street 1:1330 POST RD
Practice Address - Street 2:SUITE 4
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6039
Practice Address - Country:US
Practice Address - Phone:203-231-3359
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0081961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty