Healthcare Provider Details
I. General information
NPI: 1568280295
Provider Name (Legal Business Name): BETTER BALANCE BEHAVIORAL HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/01/2024
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2228 W MICHELLE DR
PHOENIX AZ
85023-1224
US
IV. Provider business mailing address
2228 W MICHELLE DR
PHOENIX AZ
85023-1224
US
V. Phone/Fax
- Phone: 602-698-7000
- Fax: 602-898-1117
- Phone: 972-523-6090
- Fax: 602-898-1117
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMBER
KEENAN
Title or Position: OWNER/PROVIDER
Credential: PMHNP-BC
Phone: 972-523-6090