Organization Active NPI

Life Balance Counseling LLC

  • Clinical Social Worker
  • Washington, MO
National Provider Identifier
1184965675
Registry record updated Mar 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2010041707 Issued in MO
Legal business name
LIFE BALANCE COUNSELING LLC
Practice address
426 E 5TH St
Washington, MO 63090-2811
Phone
(314) 660-7473
NPI assigned
Mar 7, 2013
Last updated
Mar 7, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2013

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

Authorized official

Name
Yael Y Diplacido-EastmanNPI 1548534605
Title
Sole MBR
Phone
(314) 660-7473

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
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 2010041707 MO Primary

Addresses

Primary practice location

426 E 5TH St
Washington, MO 63090-2811

Mailing address

426 E 5TH St
Washington, MO 63090-2811
Phone (314) 660-7473

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130725000923 MO Part B Supplier - Clinic/Group Practice 1951542471 Receives reassigned benefits from 1 practitioner
Practice locations: Union, MO

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362614400000",
    "number": "1184965675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 E 5TH ST",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630902811",
            "telephone_number": "314-660-7473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 E 5TH ST",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630902811",
            "telephone_number": "314-660-7473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE BALANCE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-07",
        "last_updated": "2013-03-07",
        "status": "A",
        "authorized_official_last_name": "DIPLACIDO-EASTMAN",
        "authorized_official_first_name": "YAEL",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "314-660-7473"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2010041707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2013; 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.