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General NPI Number Information
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NPI Number | 1962042572
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Entity Type | Organization
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Legal Business Name | BALANCE MENTAL HEALTH AND WELLNESS LLC.
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Dates
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Enumeration Date | 01/11/2020
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 405 N BEAVER ST STE 9
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-4500
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Country | US
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Telephone | 928-286-7229
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 22132
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City | FLAGSTAFF
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State | AZ
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Zip | 86002-2132
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Country | US
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Telephone | 928-286-7229
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | KATHERINE ANNE MEYER
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Credential | L.C.S.W
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Telephone | 928-814-0235
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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