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General NPI Number Information
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NPI Number | 1013486562
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Entity Type | Organization
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Legal Business Name | BALANCE INDIVIDUAL COUPLES AND FAMILY COUNSELING LLC
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Dates
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Enumeration Date | 11/14/2018
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Last Update Date | 10/03/2022
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Provider Practice Location Address
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Address Line | 37 E WILSON BRIDGE RD STE 280
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City | WORTHINGTON
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State | OH
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Zip | 43085-1106
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Country | US
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Telephone | 614-607-1125
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Fax | 614-515-4525
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Provider Business Mailing Address
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Address Line | 37 E WILSON BRIDGE RD STE 280
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City | WORTHINGTON
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State | OH
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Zip | 43085-1106
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Country | US
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Telephone | 614-607-1125
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Fax | 614-515-4525
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Authorized Official
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Title or Position | OWNER
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Name | MR. ANDREW R. MINARD
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Credential | MSW, LISW-S
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Telephone | 614-607-1125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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