=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609789288
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INNER BALANCE PSYCHOTHERAPY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/24/2026
-----------------------------------------------------
Last Update Date | 09/24/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19380 COLLINS AVE APT 1509
-----------------------------------------------------
City | SUNNY ISLES BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33160-2238
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-554-1518
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19380 COLLINS AVE APT 1509
-----------------------------------------------------
City | SUNNY ISLES BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33160-2238
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SOCIAL WORKER
-----------------------------------------------------
Name | NONNA VINOKUR
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 347-554-1518
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------