Provider Demographics
NPI:1598279176
Name:NURTURE AND BALANCE PLLC
Entity Type:Organization
Organization Name:NURTURE AND BALANCE PLLC
Other - Org Name:NURTURE AND BALANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:BIANCA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:CCMA(NHA)
Authorized Official - Phone:304-240-2698
Mailing Address - Street 1:142 N QUEEN ST STE 105
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-3312
Mailing Address - Country:US
Mailing Address - Phone:304-240-2698
Mailing Address - Fax:
Practice Address - Street 1:142 N QUEEN ST STE 105
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-3312
Practice Address - Country:US
Practice Address - Phone:304-579-1515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-19
Last Update Date:2017-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty