Provider Demographics
NPI:1568226645
Name:LIFE BALANCE COUNSELING AND SERVICES LLC
Entity Type:Organization
Organization Name:LIFE BALANCE COUNSELING AND SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:TEJRAL BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, CSW-PIP, QHMP
Authorized Official - Phone:402-290-5742
Mailing Address - Street 1:46677 CANARY PL
Mailing Address - Street 2:
Mailing Address - City:TEA
Mailing Address - State:SD
Mailing Address - Zip Code:57064-8036
Mailing Address - Country:US
Mailing Address - Phone:402-290-5742
Mailing Address - Fax:
Practice Address - Street 1:46677 CANARY PL
Practice Address - Street 2:
Practice Address - City:TEA
Practice Address - State:SD
Practice Address - Zip Code:57064-8036
Practice Address - Country:US
Practice Address - Phone:402-290-5742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty