Provider Demographics
NPI:1467751941
Name:LIFE IN BALANCE COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:LIFE IN BALANCE COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:860-550-0992
Mailing Address - Street 1:1347 E MAIN ST
Mailing Address - Street 2:UNIT 1EAST
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06450-4854
Mailing Address - Country:US
Mailing Address - Phone:860-550-0992
Mailing Address - Fax:203-639-3559
Practice Address - Street 1:1347 E MAIN ST
Practice Address - Street 2:UNIT 1EAST
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450-4854
Practice Address - Country:US
Practice Address - Phone:860-550-0992
Practice Address - Fax:203-639-3559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-23
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1499251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health