Healthcare Provider Details

I. General information

NPI: 1730993080
Provider Name (Legal Business Name): BALANCED INTEGRATIVE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

857 POST RD
WARWICK RI
02888-3360
US

IV. Provider business mailing address

857 POST RD
WARWICK RI
02888-3360
US

V. Phone/Fax

Practice location:
  • Phone: 401-398-2636
  • Fax:
Mailing address:
  • Phone: 401-398-2636
  • 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: FERNANDA FRITSCH
Title or Position: OWNER
Credential:
Phone: 401-398-2636