Provider Demographics
NPI:1538695622
Name:HEALING BALM THERAPY LLC
Entity Type:Organization
Organization Name:HEALING BALM THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:DARCELL
Authorized Official - Last Name:FRIERSON-BRISCOE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:267-259-4141
Mailing Address - Street 1:6030 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-1901
Mailing Address - Country:US
Mailing Address - Phone:267-259-4141
Mailing Address - Fax:215-549-3093
Practice Address - Street 1:207 LEEDOM ST STE 108
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3235
Practice Address - Country:US
Practice Address - Phone:267-259-4141
Practice Address - Fax:215-277-7992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-10
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009397101YP2500X
106H00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMFT01369OtherSTATE LICENSE
PAPC009397OtherSTATE LICENSE