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General NPI Number Information
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NPI Number | 1619675568
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Entity Type | Organization
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Legal Business Name | BALANCED RECOVERY COUNSELING AND CONSULTATION LLC
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 02/21/2023
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Provider Practice Location Address
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Address Line | 532 E SAINT JOSEPH ST
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City | GREEN BAY
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State | WI
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Zip | 54301-2246
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Country | US
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Telephone | 534-429-1630
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Fax | 855-674-1884
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Provider Business Mailing Address
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Address Line | 2809 E HAMILTON AVE # 4029
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City | EAU CLAIRE
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State | WI
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Zip | 54701-6863
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Country | US
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Telephone | 534-429-1630
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Fax | 855-674-1884
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Authorized Official
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Title or Position | OWNER/CLINICAL SOCIAL WORKER
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Name | MORGAN PHILLIPS
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Credential | LCSW, CSAC
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Telephone | 534-429-1630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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