Healthcare Provider Details

I. General information

NPI: 1619390952
Provider Name (Legal Business Name): BALANCE POINT WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2014
Last Update Date: 06/24/2020
Certification Date: 06/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5820 YORK RD SUITE 201
BALTIMORE MD
21212-3610
US

IV. Provider business mailing address

5820 YORK RD STE 201
BALTIMORE MD
21212-3620
US

V. Phone/Fax

Practice location:
  • Phone: 410-800-2169
  • Fax: 410-777-8742
Mailing address:
  • Phone: 410-800-2169
  • Fax: 410-777-8742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateMD

VIII. Authorized Official

Name: DR. HAYLEY I PORTER
Title or Position: CHIEF CLINICAL OFFICER
Credential: PSYD
Phone: 410-800-2169