Provider Demographics
NPI:1457001919
Name:BALANCING MINDS COUNSELING CENTER LLC
Entity Type:Organization
Organization Name:BALANCING MINDS COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPCC
Authorized Official - Phone:419-610-9570
Mailing Address - Street 1:875 SPRINGMILL ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-2045
Mailing Address - Country:US
Mailing Address - Phone:419-610-9570
Mailing Address - Fax:
Practice Address - Street 1:875 SPRINGMILL ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-2045
Practice Address - Country:US
Practice Address - Phone:419-610-9570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-28
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty