Provider Demographics
NPI:1386133551
Name:ENCORE HEALTH AND WELLNESS PLLC
Entity type:Organization
Organization Name:ENCORE HEALTH AND WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:BALOGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-465-5466
Mailing Address - Street 1:1550 W MCEWEN DR STE 300
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-1770
Mailing Address - Country:US
Mailing Address - Phone:901-465-5466
Mailing Address - Fax:901-465-9048
Practice Address - Street 1:213 LAKEVIEW RD
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38068
Practice Address - Country:US
Practice Address - Phone:901-465-5466
Practice Address - Fax:901-465-9046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-03
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD48264101YA0400X, 2084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty