Healthcare Provider Details

I. General information

NPI: 1780348607
Provider Name (Legal Business Name): BALANCED BEHAVIORAL CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2021
Last Update Date: 02/22/2025
Certification Date: 02/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 SISTER PIERRE DR STE 501
TOWSON MD
21204-7527
US

IV. Provider business mailing address

120 SISTER PIERRE DR STE 501
TOWSON MD
21204-7527
US

V. Phone/Fax

Practice location:
  • Phone: 443-977-4808
  • Fax: 410-413-7029
Mailing address:
  • Phone: 443-977-4808
  • Fax: 410-413-7029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MISS NELIA SARMIENTO
Title or Position: PSYCH PA
Credential: PA
Phone: 443-317-7268