Provider Demographics
NPI:1205666955
Name:BALANCE COUNSELING AND LIFE SOLUTIONS SERVICES PLLC
Entity type:Organization
Organization Name:BALANCE COUNSELING AND LIFE SOLUTIONS SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:940-600-0050
Mailing Address - Street 1:1716 WARD RD
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-1211
Mailing Address - Country:US
Mailing Address - Phone:940-600-0050
Mailing Address - Fax:
Practice Address - Street 1:100 E ST SW STE D
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-4722
Practice Address - Country:US
Practice Address - Phone:940-600-0050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)