Provider Demographics
NPI:1831731579
Name:BALANCE MENTAL HEALTH COUNSELING PLLC
Entity type:Organization
Organization Name:BALANCE MENTAL HEALTH COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMHC-D
Authorized Official - Prefix:
Authorized Official - First Name:TANAIRY
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNADEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MSED, LMHC, NCC
Authorized Official - Phone:631-572-8912
Mailing Address - Street 1:755 NEW YORK AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-4285
Mailing Address - Country:US
Mailing Address - Phone:631-572-8912
Mailing Address - Fax:631-351-1043
Practice Address - Street 1:755 NEW YORK AVE STE 230
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-4285
Practice Address - Country:US
Practice Address - Phone:631-572-8912
Practice Address - Fax:631-351-1043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-15
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty