Provider Demographics
NPI:1568041812
Name:HEART IN BALANCE
Entity Type:Organization
Organization Name:HEART IN BALANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:HIPP
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:616-591-4442
Mailing Address - Street 1:660 CASCADE WEST PKWY SE STE 245
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-2142
Mailing Address - Country:US
Mailing Address - Phone:616-591-4442
Mailing Address - Fax:
Practice Address - Street 1:660 CASCADE WEST PKWY SE STE 245
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-2142
Practice Address - Country:US
Practice Address - Phone:616-591-4442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty