The Brain Balance Center Inc

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

THE BRAIN BALANCE CENTER INC

Practice address

7512 N 133Rd East Ave
Owasso, OK 74055-7138

Phone

(909) 438-0351

NPI assigned

Jan 13, 2023

Last updated

Jan 13, 2023By 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

Michael Maynard, APCCNPI 1205069812

Title

Clinician

Phone

(095) 530-3207

Specialties & licenses 1

Addresses

Electronic endpoints 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.

• Michael Ray Maynard

  • Mental Health Counselor
  • Rancho Cucamonga, CA
  • NPI 1205069812
  NPD Authorized official

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

{
    "created_epoch": "1673568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673568000000",
    "number": "1205540275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7512 N 133RD EAST AVE",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740557138",
            "telephone_number": "909-438-0351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7512 N 133RD EAST AVE",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740557138",
            "telephone_number": "909-438-0351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BRAIN BALANCE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-13",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-12",
        "status": "A",
        "authorized_official_last_name": "MAYNARD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CLINICIAN",
        "authorized_official_telephone_number": "095-530-3207",
        "authorized_official_credential": "APCC"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.thebrainbalancecenter.com",
            "affiliation": "N",
            "address_1": "7512 N 133rd East Ave",
            "city": "Owasso",
            "state": "OK",
            "country_code": "US",
            "postal_code": "740557138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Marriage & Family Therapist in Owasso, OK
• Providers in Owasso, OK by specialty
• Marriage & Family Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; 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.