MEDICARE: BALANCE WITHIN: THERAPY AND WELLNESS PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1245126127
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BALANCE WITHIN: THERAPY AND WELLNESS PLLC

Provider Business Mailing Address
First Line	:	318 S SOUTH ST STE 6B-1113
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28052-4379
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	318 S SOUTH ST STE 6B-1113
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28052-4379
Country	:	US
Telephone Number	:	980-349-7060
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HANNAH PEGRAM
Credential	:	MSW, LCSW
Telephone Number	:	980-349-7060

Provider Enumeration Date	:	06/16/2025
Last Update Date	:	06/17/2025

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