Provider Demographics
NPI:1134893936
Name:BALANCED EMOTIONS AND RESILIENCE PLLC
Entity type:Organization
Organization Name:BALANCED EMOTIONS AND RESILIENCE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TE'HA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMPS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:910-364-4191
Mailing Address - Street 1:167 FAIRVIEW RD APT 206
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-6572
Mailing Address - Country:US
Mailing Address - Phone:910-541-1680
Mailing Address - Fax:
Practice Address - Street 1:5803 COLD HARBOR CT
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4016
Practice Address - Country:US
Practice Address - Phone:910-541-1680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)