Provider Demographics
NPI:1285267724
Name:B BALANCED COUNSELING & WELLNESS, PLLC
Entity type:Organization
Organization Name:B BALANCED COUNSELING & WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / LCMHC
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:TODD
Authorized Official - Suffix:
Authorized Official - Credentials:MAED, LCMHC
Authorized Official - Phone:336-607-5822
Mailing Address - Street 1:939 BURKE ST STE F
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-2575
Mailing Address - Country:US
Mailing Address - Phone:336-607-5822
Mailing Address - Fax:336-346-8130
Practice Address - Street 1:939 BURKE ST STE F
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-2575
Practice Address - Country:US
Practice Address - Phone:336-607-5822
Practice Address - Fax:336-346-8130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-12
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCPC15482OtherPROFESSIONAL COUNSELING CORPORATION
NC13669OtherLICENSED CLINICAL MENTAL HEALTH COUNSELOR