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General NPI Number Information
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NPI Number | 1023818671
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Entity Type | Organization
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Legal Business Name | BALANCED PSYCHOTHERAPY PLLC
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 317 WILDROSE CT
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City | FERNLEY
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State | NV
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Zip | 89408-9576
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Country | US
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Telephone | 775-238-6241
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 82
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City | FERNLEY
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State | NV
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Zip | 89408-0082
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Country | US
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Telephone | 775-238-6241
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Fax |
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | DALLIS BERNAIX
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Credential | LMFTI
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Telephone | 775-238-6241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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