Provider Demographics
NPI:1699422170
Name:CHASING BALANCED WELLNESS, LLC
Entity type:Organization
Organization Name:CHASING BALANCED WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC, CPCS
Authorized Official - Phone:770-268-0969
Mailing Address - Street 1:4850 SUGARLOAF PKWY STE 209-323
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-2859
Mailing Address - Country:US
Mailing Address - Phone:770-268-0969
Mailing Address - Fax:
Practice Address - Street 1:4850 SUGARLOAF PKWY STE 209-323
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-2859
Practice Address - Country:US
Practice Address - Phone:770-268-0969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty