NPI Code Details Logo

NPI 1104798107

NPI 1104798107 : BALANCING MINDS, PLLC : MISSOULA, MT

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1104798107
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    BALANCING MINDS, PLLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    09/19/2025
-----------------------------------------------------
    Last Update Date     |    09/19/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2501 HALF HITCH DR 
-----------------------------------------------------
    City                 |    MISSOULA
-----------------------------------------------------
    State                |    MT
-----------------------------------------------------
    Zip                  |    59808-5438
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    406-552-9188
-----------------------------------------------------
    Fax                  |    406-441-4447
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    2501 HALF HITCH DR 
-----------------------------------------------------
    City                 |    MISSOULA
-----------------------------------------------------
    State                |    MT
-----------------------------------------------------
    Zip                  |    59808-5438
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    406-552-9188
-----------------------------------------------------
    Fax                  |    406-441-4447
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER
-----------------------------------------------------
    Name                 |     ANGELICA  MOTHKA 
-----------------------------------------------------
    Credential           |    LCSW
-----------------------------------------------------
    Telephone            |    406-552-9188
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    1041C0700X
-----------------------------------------------------
    Taxonomy Name        |    Clinical Social Worker
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.