Healthcare Provider Details

I. General information

NPI: 1467167924
Provider Name (Legal Business Name): BALANCE AND BEHAVIOR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2023
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3321 GEORGIA AVE NW UNIT 3026
WASHINGTON DC
20010-7501
US

IV. Provider business mailing address

3321 GEORGIA AVE NW UNIT 3026
WASHINGTON DC
20010-7501
US

V. Phone/Fax

Practice location:
  • Phone: 202-880-6167
  • Fax: 202-851-5080
Mailing address:
  • Phone: 202-880-6167
  • Fax: 202-851-5080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: XAVIER BUTLER
Title or Position: OPERATING MANAGER
Credential:
Phone: 202-880-6167