NPIMap

Organization Active NPI

Mo Smiles LLC

Doing business as Balanced Mind Counseling

  • Professional Counselor
  • Glendale, AZ
National Provider Identifier
1235976747
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
MO SMILES LLC
Doing business as
Balanced Mind Counseling
Practice address
7200 W Bell Rd Ste E102
Glendale, AZ 85308-8534
Phone
(623) 934-9191
NPI assigned
Jul 11, 2024
Last updated
Apr 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Authorized official

Name
Justin Terry Candelas
Title
Office Manager
Phone
(303) 582-4157

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

7200 W Bell Rd Ste E102
Glendale, AZ 85308-8534

Mailing address

7200 W Bell Rd Ste E102
Glendale, AZ 85308-8534

Other practice location 1

19420 N 59th Ave Ste C253
Glendale, AZ 85308-6897
Phone (623) 934-9191

Other names 1

  • Balanced Mind Counseling Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Balanced Mind Counseling8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

19420 N 59th Ave
Ste C253
Glendale, AZ 85308
Phone (623) 934-9191

7200 W Bell Rd
Ste E102
Glendale, AZ 85308
Phone (623) 934-9191

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743638400000",
    "number": "1235976747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 W BELL RD STE E102",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 W BELL RD STE E102",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088534",
            "telephone_number": "623-934-9191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19420 N 59th Ave Ste C253",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853086897",
            "country_code": "US",
            "telephone_number": "623-934-9191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MO SMILES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-11",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A",
        "authorized_official_last_name": "CANDELAS",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "TERRY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "303-582-4157"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Balanced Mind Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Balanced Mind Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; 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.