Provider Demographics
NPI:1790167393
Name:PAULA FLEMING
Entity Type:Organization
Organization Name:PAULA FLEMING
Other - Org Name:BEHAVIOR BALANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED INDEPENDENT PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LPHA
Authorized Official - Phone:843-756-7171
Mailing Address - Street 1:586 HIGHWAY 701 N
Mailing Address - Street 2:A
Mailing Address - City:LORIS
Mailing Address - State:SC
Mailing Address - Zip Code:29569-2473
Mailing Address - Country:US
Mailing Address - Phone:843-756-7171
Mailing Address - Fax:843-756-7176
Practice Address - Street 1:586 HIGHWAY 701 N
Practice Address - Street 2:A
Practice Address - City:LORIS
Practice Address - State:SC
Practice Address - Zip Code:29569-2473
Practice Address - Country:US
Practice Address - Phone:843-756-7171
Practice Address - Fax:843-756-7176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1050101YA0400X
SC5489101YP2500X
NCS4500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3410166Medicaid
NC6102664Medicaid
NC6005440Medicaid
NC2348053Medicare PIN