Create Balance, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

CREATE BALANCE, LLC

Practice address

155 Park Ave Ste 21
Cranston, RI 02905-2627

Phone

(401) 753-4325

NPI assigned

Jan 22, 2020

Last updated

Jan 22, 2020By 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

Kerri Weaver, LMHC

Title

Owner/ LMHC

Phone

(401) 447-4587

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579651200000",
    "number": "1134759871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 PARK AVE STE 21",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029052627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 PARK AVE STE 21",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029052627",
            "telephone_number": "401-753-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATE BALANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-22",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "KERRI",
        "authorized_official_title_or_position": "OWNER/ LMHC",
        "authorized_official_telephone_number": "401-447-4587",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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