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General NPI Number Information
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NPI Number | 1528986023
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Entity Type | Organization
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Legal Business Name | BALANCED PATH THERAPIES, LLC
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Dates
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Enumeration Date | 07/09/2026
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Last Update Date | 07/17/2026
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Provider Practice Location Address
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Address Line | 2001 S MAIN ST STE 105
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City | BLACKSBURG
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State | VA
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Zip | 24060-6667
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Country | US
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Telephone | 540-200-8625
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Fax |
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Provider Business Mailing Address
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Address Line | 506 FOREST HILL DR
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City | BLACKSBURG
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State | VA
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Zip | 24060-5908
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Country | US
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Telephone | 540-420-5226
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | PETER GOLLADAY
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Credential | LCSW
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Telephone | 540-200-8625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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