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General NPI Number Information
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NPI Number | 1487519807
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Entity Type | Organization
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Legal Business Name | MIND AND BODY BALANCED LLC
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Dates
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Enumeration Date | 12/18/2025
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 47 WATERBURY RD STE 322
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City | PROSPECT
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State | CT
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Zip | 06712-1256
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Country | US
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Telephone | 914-252-3976
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Fax | 914-416-5658
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Provider Business Mailing Address
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Address Line | 47 WATERBURY RD STE 322
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City | PROSPECT
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State | CT
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Zip | 06712-1256
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Country | US
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Telephone | 914-252-3976
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Fax | 914-416-5658
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | CASSANDRA LUCY WILLIAMS
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Credential | NP
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Telephone | 914-252-3976
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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