Balance for Healthy Living, PC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C1780 Issued in OR

Legal business name

BALANCE FOR HEALTHY LIVING, PC

Practice address

6129 NE Skidmore St
Portland, OR 97218-2227

Phone

(503) 407-9232

NPI assigned

Sep 14, 2010

Organization subpart

No

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

Authorized official

Name

Tirzah D JacobNPI 1669497467

Title

Practice Owner

Phone

(503) 407-9232

Specialties & licenses 3

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tirzah D Jacob, LPC

  • Professional Counselor
  • Portland, OR
  • NPI 1669497467

  Addiction (Substance Use Disorder)

  NPD Authorized official

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1265740096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6129 NE SKIDMORE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972182227",
            "telephone_number": "503-407-9232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6129 NE SKIDMORE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972182227",
            "telephone_number": "503-407-9232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCE FOR HEALTHY LIVING, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-14",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "TIRZAH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "503-407-9232"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "OR",
            "license": "C1780",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C1780",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C1780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500601179",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11607801",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Candi L Balabon, CADC-R/CRM/PSS
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• Professional Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.