NPIMap

Organization Active NPI

Balance Ground Counseling LLC

  • Mental Health Counselor
  • Fayetteville, GA
National Provider Identifier
1053937490
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
BALANCE GROUND COUNSELING LLC
Practice address
240 Lofty Eagle LN
Fayetteville, GA 30214-3531
Phone
(770) 756-6037
NPI assigned
Jun 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Authorized official

Name
Ms. Letrice Deloach, LPCNPI 1730682865
Title
Ceo
Phone
(404) 202-2757

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

240 Lofty Eagle LN
Fayetteville, GA 30214-3531

Mailing address

240 Lofty Eagle LN
Fayetteville, GA 30214-3531
Phone (770) 756-6037

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592784000000",
    "number": "1053937490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 LOFTY EAGLE LN",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302143531",
            "telephone_number": "770-756-6037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 LOFTY EAGLE LN",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302143531",
            "telephone_number": "770-756-6037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCE GROUND COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-22",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A",
        "authorized_official_last_name": "DELOACH",
        "authorized_official_first_name": "LETRICE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-202-2757",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; 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.