Provider Demographics
NPI:1700085750
Name:BALANCED ENERGY PARTNERSHIP, LLC
Entity Type:Organization
Organization Name:BALANCED ENERGY PARTNERSHIP, LLC
Other - Org Name:FAMILY COUNSELING OF CHESHIRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GRETCHEN
Authorized Official - Middle Name:STARK
Authorized Official - Last Name:WENT
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:203-464-1249
Mailing Address - Street 1:558 MAPLE AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-2100
Mailing Address - Country:US
Mailing Address - Phone:203-250-9654
Mailing Address - Fax:
Practice Address - Street 1:558 MAPLE AVE STE 2
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-2100
Practice Address - Country:US
Practice Address - Phone:203-250-9654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004254207Medicaid
CT004254992Medicaid