Provider Demographics
NPI:1285329839
Name:A BALANCED APPROACH TO BEHAVIORAL & MENTAL HEALTH
Entity type:Organization
Organization Name:A BALANCED APPROACH TO BEHAVIORAL & MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMMALA
Authorized Official - Middle Name:SHETEF
Authorized Official - Last Name:ROUNDTREE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:703-216-1812
Mailing Address - Street 1:1727 KING ST STE 3
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-2700
Mailing Address - Country:US
Mailing Address - Phone:571-695-2386
Mailing Address - Fax:571-695-2252
Practice Address - Street 1:1727 KING ST STE 3
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-2700
Practice Address - Country:US
Practice Address - Phone:571-695-2386
Practice Address - Fax:571-695-2252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-10
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty