Provider Demographics
NPI:1679216907
Name:BALANCED LIFE COUNSELING
Entity Type:Organization
Organization Name:BALANCED LIFE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARBONE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:978-530-7735
Mailing Address - Street 1:300 ANDOVER ST STE 255
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-1526
Mailing Address - Country:US
Mailing Address - Phone:978-530-7735
Mailing Address - Fax:
Practice Address - Street 1:300 ANDOVER ST STE 255
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-1526
Practice Address - Country:US
Practice Address - Phone:781-435-7510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health