Provider Demographics
NPI:1467901793
Name:MENTAL BALANCE- COGNITIVE BEHAVIORAL THERAPY
Entity Type:Organization
Organization Name:MENTAL BALANCE- COGNITIVE BEHAVIORAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCALLISTER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:610-529-0936
Mailing Address - Street 1:7404 HENRY AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-1402
Mailing Address - Country:US
Mailing Address - Phone:610-529-0936
Mailing Address - Fax:
Practice Address - Street 1:119 HARRY ST
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-1821
Practice Address - Country:US
Practice Address - Phone:610-529-0936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005784251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health