Provider Demographics
NPI:1932061033
Name:LIFE BALANCE PSYCHIATRY
Entity type:Organization
Organization Name:LIFE BALANCE PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-C
Authorized Official - Prefix:MS
Authorized Official - First Name:SIKIRAT
Authorized Official - Middle Name:OLABIMPE
Authorized Official - Last Name:ABOLARIN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:954-557-1420
Mailing Address - Street 1:4184 SAWGRASS DR
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-1255
Mailing Address - Country:US
Mailing Address - Phone:954-557-1420
Mailing Address - Fax:
Practice Address - Street 1:4184 SAWGRASS DR
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-1255
Practice Address - Country:US
Practice Address - Phone:954-557-1420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-26
Last Update Date:2025-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty