Healthcare Provider Details

I. General information

NPI: 1932724028
Provider Name (Legal Business Name): BALANCING EDEN COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2020
Last Update Date: 08/12/2022
Certification Date: 06/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2607 WOODRUFF RD STE E-1069
SIMPSONVILLE SC
29681-4803
US

IV. Provider business mailing address

211 JASMINE COVE CIR
SIMPSONVILLE SC
29680-7170
US

V. Phone/Fax

Practice location:
  • Phone: 864-214-6393
  • Fax: 864-568-7250
Mailing address:
  • Phone: 859-321-8050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. ASHA N GRIFFIN
Title or Position: OWNER/LICENSED PROFESSIONAL COUNSEL
Credential: LPC
Phone: 859-321-8050