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General NPI Number Information
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NPI Number | 1164061727
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Entity Type | Organization
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Legal Business Name | BALANCED LIFE COUNSELING LLC
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Dates
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Enumeration Date | 12/31/2019
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 4041 UNIVERSITY DR STE 200
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City | FAIRFAX
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State | VA
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Zip | 22030-3410
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Country | US
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Telephone | 202-760-1998
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Fax |
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Provider Business Mailing Address
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Address Line | 4041 UNIVERSITY DR STE 200CR
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City | FAIRFAX
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State | VA
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Zip | 22030-3414
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Country | US
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Telephone | 202-760-1998
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARY ARLEDGE
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Credential |
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Telephone | 202-760-1998
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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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