Provider Demographics
NPI:1902275209
Name:LIFE BALANCE COUNSELING
Entity Type:Organization
Organization Name:LIFE BALANCE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JANELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:720-940-9299
Mailing Address - Street 1:2323 S TROY ST STE 256
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1946
Mailing Address - Country:US
Mailing Address - Phone:720-940-9299
Mailing Address - Fax:
Practice Address - Street 1:2323 S TROY ST STE 256
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1946
Practice Address - Country:US
Practice Address - Phone:720-940-9299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCERTIFICATE NLC13409305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization