Provider Demographics
NPI:1336930841
Name:INNER BALANCE PSYCHIATRY PLLC
Entity type:Organization
Organization Name:INNER BALANCE PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:LAROCHE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, MSN, PMHNP-BC
Authorized Official - Phone:386-222-3978
Mailing Address - Street 1:1235 PROVIDENCE BLVD STE R53
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-7363
Mailing Address - Country:US
Mailing Address - Phone:386-222-3978
Mailing Address - Fax:386-603-0971
Practice Address - Street 1:1869 ODHAM DR
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32738-7739
Practice Address - Country:US
Practice Address - Phone:386-222-3978
Practice Address - Fax:386-603-0971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health