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NPI Code Detail

MEDICARE: WHOLE BALANCE HEALTH, LLC

MEDICARE: WHOLE BALANCE HEALTH, 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
1101YP2500XProfessional CounselorCO

General Provider Information

NPI Number : 1700310968
Entity Type Code : Organization
Provider Name (Legal Business Name) : WHOLE BALANCE HEALTH, LLC
Provider Business Mailing Address
First Line : 5390 N ACADEMY BLVD
Second Line : STE 330
City : COLORADO SPRINGS
State : CO
Zip : 80918-4176
Country : US
Telephone Number : 719-466-1165
Fax Number : 719-362-4447
Provider Business Practice Location Address
First Line : 5390 N ACADEMY BLVD
Second Line : STE 330
City : COLORADO SPRINGS
State : CO
Zip : 80918-4176
Country : US
Telephone Number : 719-466-1165
Fax Number : 719-362-4447
Authorized Official
Title or Position : OWNER
Name : CATHERINE DURST
Credential : LPC
Telephone Number : 719-466-1165
Provider Enumeration Date : 04/14/2017
Last Update Date : 09/19/2024

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Directions to “WHOLE BALANCE HEALTH, LLC ” Practice Location

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