A Balanced Life: Individual, Family and Child Therapy, Inc

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCSW24256 Issued in CA

Legal business name

A BALANCED LIFE: INDIVIDUAL, FAMILY AND CHILD THERAPY, INC

Practice address

2100 Eloise Ave
South Lake Tahoe, CA 96150-4306

Phone

(530) 544-1748

Fax

(530) 544-1728

NPI assigned

Feb 13, 2017

Last updated

Feb 13, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Lindsay Simon, LMFT

Title

Owner/Clinical Director

Phone

(530) 544-1748

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Riann Jeanine Giovacchini

  • Clinical Social Worker
  • South Lake Tahoe, CA
  • NPI 1396216693
  NPD (past)
• Marianna Randolph, LCSW

  • Clinical Social Worker
  • South Lake Tahoe, CA
  • NPI 1609150853
  NPD (past)

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1083153837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7152",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961580152",
            "telephone_number": "530-544-1748",
            "fax_number": "530-544-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 ELOISE AVE",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961504306",
            "telephone_number": "530-544-1748",
            "fax_number": "530-544-1728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A BALANCED LIFE: INDIVIDUAL, FAMILY AND CHILD THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "LINDSAY",
        "authorized_official_title_or_position": "OWNER/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "530-544-1748",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LCSW24256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A Balanced Life: Individual, Family & Child Therapy, Inc.
• A Westfall Dental Corporation (Tahoe Valley Dental)
• A Westfall Dental Corporation
• Abby Cohen MD a Medical Corporation
• Stephen Paul Abelow, M.D.
• Jason Randall Acevedo, DDS

• Mental Health Counselor in South Lake Tahoe, CA
• Providers in South Lake Tahoe, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; 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.