Provider Demographics
NPI:1235583378
Name:BEHAVIOR BALANCE, LLC
Entity Type:Organization
Organization Name:BEHAVIOR BALANCE, LLC
Other - Org Name:BEHAVIOR BALANCE, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CALHOUN
Authorized Official - Suffix:
Authorized Official - Credentials:LPCS,
Authorized Official - Phone:843-756-7171
Mailing Address - Street 1:586 HIGHWAY 701 N
Mailing Address - Street 2:SUITE A
Mailing Address - City:LORIS
Mailing Address - State:SC
Mailing Address - Zip Code:29569-2473
Mailing Address - Country:US
Mailing Address - Phone:843-756-7171
Mailing Address - Fax:843-756-7176
Practice Address - Street 1:3439 CASEY ST
Practice Address - Street 2:
Practice Address - City:LORIS
Practice Address - State:SC
Practice Address - Zip Code:29569
Practice Address - Country:US
Practice Address - Phone:843-756-7171
Practice Address - Fax:843-756-7176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-14
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty