MEDICARE: BALANCED APPROACH COUNSELING SERVICES,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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1851986640
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BALANCED APPROACH COUNSELING SERVICES,LLC

Provider Business Mailing Address
First Line	:	336 TURKEY TOP RD
Second Line	:
City	:	PORT MURRAY
State	:	NJ
Zip	:	07865-3003
Country	:	US
Telephone Number	:	908-625-0989
Fax Number	:

Provider Business Practice Location Address
First Line	:	336 TURKEY TOP RD
Second Line	:
City	:	PORT MURRAY
State	:	NJ
Zip	:	07865-3003
Country	:	US
Telephone Number	:	908-625-0989
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL THERAPIST
Name	:	MR. GREGORY CHARLES POTTER
Credential	:	LCSW, LCADC
Telephone Number	:	908-625-0989

Provider Enumeration Date	:	03/04/2021
Last Update Date	:	03/04/2021

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