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General NPI Number Information
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NPI Number | 1831731579
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Entity Type | Organization
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Legal Business Name | BALANCE MENTAL HEALTH COUNSELING PLLC
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Dates
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Enumeration Date | 10/15/2019
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 755 NEW YORK AVE STE 230
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City | HUNTINGTON
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State | NY
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Zip | 11743-4285
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Country | US
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Telephone | 631-572-8912
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Fax | 631-351-1043
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Provider Business Mailing Address
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Address Line | 755 NEW YORK AVE STE 230
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City | HUNTINGTON
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State | NY
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Zip | 11743-4285
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Country | US
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Telephone | 631-572-8912
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Fax | 631-351-1043
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Authorized Official
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Title or Position | LMHC-D
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Name | TANAIRY FERNADEZ
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Credential | MS.ED, LMHC, NCC
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Telephone | 631-572-8912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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