Live Life Balanced Healing, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

LIVE LIFE BALANCED HEALING, LLC

Practice address

2546 Johnson St NE
Minneapolis, MN 55418-3941

Phone

(612) 444-1655

NPI assigned

Sep 18, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Shireen Ghanatabadi, MA, LPCC, SEPNPI 1952809899

Title

Owner/Therapist

Phone

(612) 444-1655

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 1

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.

• Shireen June Ghanatabadi, MA, LPCC

  • Professional Counselor
  • Minneapolis, MN
  • NPI 1952809899
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694995200000",
    "number": "1184402505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2546 JOHNSON ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554183941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2546 JOHNSON ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554183941",
            "telephone_number": "612-444-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE LIFE BALANCED HEALING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-12",
        "status": "A",
        "authorized_official_last_name": "GHANATABADI",
        "authorized_official_first_name": "SHIREEN",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "612-444-1655",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA, LPCC, SEP"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wei Liu, L.AC
• Xuejing Liu
• Yingying Liu
• Fannie Livaditis, LMT
• Live Learn Hope Services
• Livecare 24 Inc
• Michelle Marie Lively, LSW
• Gary R Livermore, PHD
• Grace Phyllis Livermore, LICSW
• Living Waters Youth

• Adult Mental Health Clinic/Center in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Adult Mental Health Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.