Provider Demographics
NPI:1962042572
Name:BALANCE MENTAL HEALTH AND WELLNESS LLC.
Entity Type:Organization
Organization Name:BALANCE MENTAL HEALTH AND WELLNESS LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:928-814-0235
Mailing Address - Street 1:PO BOX 22132
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86002-2132
Mailing Address - Country:US
Mailing Address - Phone:928-286-7229
Mailing Address - Fax:
Practice Address - Street 1:405 N BEAVER ST STE 9
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-4500
Practice Address - Country:US
Practice Address - Phone:928-286-7229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-11
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)