Healthcare Provider Details

I. General information

NPI: 1477430940
Provider Name (Legal Business Name): INNER BALANCE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1158 PROFESSIONAL DR STE F
WILLIAMSBURG VA
23185-6618
US

IV. Provider business mailing address

4501 E MAIN ST APT 102
RICHMOND VA
23231-1101
US

V. Phone/Fax

Practice location:
  • Phone: 360-471-9022
  • Fax:
Mailing address:
  • Phone: 360-471-9022
  • Fax: 360-471-9022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ABIODUN O RAHMAN
Title or Position: DIRECTOR
Credential: QMHP
Phone: 360-471-9022