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NPI Code Detail

MEDICARE: CREATING LIFE'S BALANCE, INC.

MEDICARE: CREATING LIFE'S BALANCE, INC.
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1902497068
Entity Type Code : Organization
Provider Name (Legal Business Name) : CREATING LIFE'S BALANCE, INC.
Provider Business Mailing Address
First Line : 49 JEFFREY DR
Second Line :
City : AMHERST
State : NY
Zip : 14228-1930
Country : US
Telephone Number : 716-640-1089
Fax Number :
Provider Business Practice Location Address
First Line : 1416 SWEET HOME RD STE 1
Second Line :
City : AMHERST
State : NY
Zip : 14228-2786
Country : US
Telephone Number : 716-640-1089
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MRS. COLLEEN ALOIAN
Credential : LMHC
Telephone Number : 716-640-1089
Provider Enumeration Date : 02/01/2021
Last Update Date : 02/01/2021

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