MEDICARE: BALANCING LIFE & KIDS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	106H00000X	Marriage & Family Therapist
3	106S00000X	Behavior Technician
4	251S00000X	Community/Behavioral Health Agency
5	103TC1900X	Counseling Psychologist
6	103K00000X	Behavior Analyst
7	261QM0850X	Adult Mental Health Clinic/Center
8	261QM0855X	Adolescent and Children Mental Health Clinic/Center
9	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1114634102
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BALANCING LIFE & KIDS, INC.

Provider Business Mailing Address
First Line	:	818 ALEXANDER AVE
Second Line	:
City	:	DREXEL HILL
State	:	PA
Zip	:	19026-4402
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 GAY ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19127-1309
Country	:	US
Telephone Number	:	484-558-0657
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	MRS. KISHNA CELCE
Credential	:	CTRC, CTS
Telephone Number	:	484-558-0657

Provider Enumeration Date	:	10/31/2022
Last Update Date	:	01/25/2025

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