Provider Demographics
NPI:1881056158
Name:BALIT, GINA (MA, LMFT, ATR)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:BALIT
Suffix:
Gender:F
Credentials:MA, LMFT, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20300 VENTURA BLVD STE 380
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-0919
Mailing Address - Country:US
Mailing Address - Phone:818-533-1897
Mailing Address - Fax:
Practice Address - Street 1:20300 VENTURA BLVD STE 380
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-0919
Practice Address - Country:US
Practice Address - Phone:818-533-1897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-24
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF72714106H00000X
CALMFT115140106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist