=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508315805
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BALANCED LIVING COUNSELING, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/27/2016
-----------------------------------------------------
Last Update Date | 10/12/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7955 E ARAPAHOE CT SUITE 1400
-----------------------------------------------------
City | CENTENNIAL
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80112-6820
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-929-4406
-----------------------------------------------------
Fax | 303-694-0754
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7955 E ARAPAHOE CT SUITE 1400
-----------------------------------------------------
City | CENTENNIAL
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80112-6820
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-929-4406
-----------------------------------------------------
Fax | 303-694-0754
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | THERAPIST/OWNER
-----------------------------------------------------
Name | DEBORAH BABCOCK
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 303-929-4406
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 2914
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------