Healthcare Provider Details

I. General information

NPI: 1104794676
Provider Name (Legal Business Name): BALANCE BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 E OSAGE RD STE 300
DERBY KS
67037-2290
US

IV. Provider business mailing address

1721 E OSAGE RD STE 300
DERBY KS
67037-2290
US

V. Phone/Fax

Practice location:
  • Phone: 316-519-8662
  • Fax:
Mailing address:
  • Phone: 316-519-8662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE MCCLELLAN
Title or Position: OWNER/PROVIDER
Credential: PMHNP-C
Phone: 316-519-8662