Provider Demographics
NPI:1245002005
Name:BALANCE BAYLY THERAPY
Entity type:Organization
Organization Name:BALANCE BAYLY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:HANNALLAH
Authorized Official - Last Name:BAYLY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:301-461-7419
Mailing Address - Street 1:4809 FORT SUMNER DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-2464
Mailing Address - Country:US
Mailing Address - Phone:301-461-7419
Mailing Address - Fax:
Practice Address - Street 1:4809 FORT SUMNER DR
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816-2464
Practice Address - Country:US
Practice Address - Phone:301-461-7419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty