Provider Demographics
NPI:1629631817
Name:LIFE BALANCE COUNSELING LLC
Entity Type:Organization
Organization Name:LIFE BALANCE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:SALAZAR
Authorized Official - Last Name:TAPIA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-421-1788
Mailing Address - Street 1:1225 LANGFORD WAY
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-4785
Mailing Address - Country:US
Mailing Address - Phone:208-421-0036
Mailing Address - Fax:
Practice Address - Street 1:1239 FILER AVE E # C
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-4118
Practice Address - Country:US
Practice Address - Phone:208-421-1788
Practice Address - Fax:208-734-0211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-15
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health