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General NPI Number Information
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NPI Number | 1467328351
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Entity Type | Organization
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Legal Business Name | BALANCED LIVING COUNSELING AND CONSULTING SERVICES
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Dates
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Enumeration Date | 10/16/2025
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 14507 ONEAL RD
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City | GULFPORT
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State | MS
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Zip | 39503-2411
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Country | US
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Telephone | 334-437-0706
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Fax |
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Provider Business Mailing Address
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Address Line | 14507 ONEAL RD
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City | GULFPORT
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State | MS
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Zip | 39503-2411
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Country | US
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Telephone | 334-437-0706
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. ALICIA BROWN
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Credential | PH.D.
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Telephone | 334-437-0706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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