Eclectic Balance LLC

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

ECLECTIC BALANCE LLC

Practice address

1200 High Ridge Rd
Humanly Suite - 2ND Floor
Stamford, CT 06905-1223

Phone

(201) 477-8751

NPI assigned

Sep 28, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Judith Liu, LCSWNPI 1003359712

Title

Owner/President

Phone

(914) 330-5662

Specialties & licenses 1

Addresses

Tax ID family

Eclectic Balance2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Eclectic Balance LLC

  • Clinical Social Worker
  • White Plains, NY
  • NPI 1245901040
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Judith Liu, LCSW

  • Clinical Social Worker
  • Stamford, CT
  • NPI 1003359712
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687910400000",
    "number": "1053083147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 HIGH RIDGE RD",
            "address_2": "HUMANLY SUITE - 2ND FLOOR",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069051223",
            "telephone_number": "201-477-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 HIGH RIDGE RD",
            "address_2": "HUMANLY SUITE - 2ND FLOOR",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069051223",
            "telephone_number": "201-477-8751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "48 Burd St Ste 306",
            "address_purpose": "LOCATION",
            "city": "Nyack",
            "state": "NY",
            "postal_code": "109603257",
            "country_code": "US",
            "telephone_number": "201-477-8751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ECLECTIC BALANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "914-330-5662",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Stamford, CT
• Providers in Stamford, CT by specialty
• Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.