Healthcare Provider Details

I. General information

NPI: 1023818671
Provider Name (Legal Business Name): BALANCED PSYCHOTHERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2025
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 BRINKBY AVE STE 206
RENO NV
89509-4345
US

IV. Provider business mailing address

PO BOX 82
FERNLEY NV
89408-0082
US

V. Phone/Fax

Practice location:
  • Phone: 775-238-6241
  • Fax:
Mailing address:
  • Phone: 775-238-6241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DALLIS BERNAIX
Title or Position: THERAPIST/OWNER
Credential: LMFTI
Phone: 775-238-6241