Provider Demographics
NPI:1962254748
Name:POSITIVE BALANCE WELLNESS AND PSYCHOTHERAPY
Entity type:Organization
Organization Name:POSITIVE BALANCE WELLNESS AND PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANN MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BERG
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:224-246-1306
Mailing Address - Street 1:727 N WALDEN DR
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-8648
Mailing Address - Country:US
Mailing Address - Phone:224-246-1306
Mailing Address - Fax:
Practice Address - Street 1:1608 W COLONIAL PKWY STE 105
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:224-541-0122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health