MEDICARE: BALANCED LIFE COUNSELING LLC

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	101YP2500X	Professional Counselor	2013039915	MO

General Provider Information

NPI Number	:	1255798708
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BALANCED LIFE COUNSELING LLC

Provider Business Mailing Address
First Line	:	7608 E 117TH TER
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64134-3925
Country	:	US
Telephone Number	:	816-882-3845
Fax Number	:

Provider Business Practice Location Address
First Line	:	7608 E 117TH TER
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64134-3925
Country	:	US
Telephone Number	:	816-882-3845
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	EUGENE BATTLE
Credential	:	LPC
Telephone Number	:	816-882-3845

Provider Enumeration Date	:	01/27/2016
Last Update Date	:	01/27/2016

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