Provider Demographics
NPI:1336732106
Name:CULTIVATING BALANCE COUNSELING, LLC
Entity type:Organization
Organization Name:CULTIVATING BALANCE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND LEAD COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHELSIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCOGGIN-CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, CRADC
Authorized Official - Phone:224-836-1633
Mailing Address - Street 1:1608 W COLONIAL PKWY STE 203
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:IL
Mailing Address - Zip Code:60067-4755
Mailing Address - Country:US
Mailing Address - Phone:224-836-1633
Mailing Address - Fax:
Practice Address - Street 1:1608 W COLONIAL PKWY STE 203
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:IL
Practice Address - Zip Code:60067-4755
Practice Address - Country:US
Practice Address - Phone:224-836-1633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-12
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty