Provider Demographics
NPI:1700632866
Name:BALANCED MIND COUNSELING, LLC
Entity type:Organization
Organization Name:BALANCED MIND COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:GREGORY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:270-215-7190
Mailing Address - Street 1:920 FREDERICA ST STE 205
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-6200
Mailing Address - Country:US
Mailing Address - Phone:270-215-7190
Mailing Address - Fax:270-228-2991
Practice Address - Street 1:920 FREDERICA ST STE 205
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-6200
Practice Address - Country:US
Practice Address - Phone:270-215-7190
Practice Address - Fax:270-228-2991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-29
Last Update Date:2024-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty