Healthcare Provider Details

I. General information

NPI: 1346155355
Provider Name (Legal Business Name): BALANCED PSYCHIATRY & ENDOCRINE WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6324 CALLAWAY SQ W
NEW ALBANY OH
43054-8772
US

IV. Provider business mailing address

6324 CALLAWAY SQ W
NEW ALBANY OH
43054-8772
US

V. Phone/Fax

Practice location:
  • Phone: 740-646-9876
  • Fax: 740-205-8662
Mailing address:
  • Phone: 740-646-9876
  • Fax: 740-205-8662

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: AMY JILES
Title or Position: LPN
Credential: LPN
Phone: 740-646-6353