Healthcare Provider Details

I. General information

NPI: 1215410980
Provider Name (Legal Business Name): BRITANY BALCH MA, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2018
Last Update Date: 08/25/2023
Certification Date: 08/25/2023
Deactivation Date: 07/21/2023
Reactivation Date: 08/24/2023

III. Provider practice location address

1035 S SEMORAN BLVD STE 2-1047
WINTER PARK FL
32792-5526
US

IV. Provider business mailing address

840 LOMBARD ST APT 209
ORLANDO FL
32807-5251
US

V. Phone/Fax

Practice location:
  • Phone: 321-401-7026
  • Fax: 321-401-7026
Mailing address:
  • Phone: 772-240-2973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMT4707
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: