Life Well Balanced LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2013045632 Issued in MO

Legal business name

LIFE WELL BALANCED LLC

Practice address

103 Lincoln St
O Fallon, MO 63366-1603

Phone

(636) 443-3704

Fax

(636) 294-0530

NPI assigned

Apr 11, 2018

Last updated

Apr 11, 2018By 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

Sara Ann Carter, LCSW

Title

Owner

Phone

(636) 443-3704

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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.

• Sara Ann Carter-Jameson, L.C.S.W

  • Clinical Social Worker
  • O'Fallon, MO
  • NPI 1073063343
  Medicare reassignment

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523404800000",
    "number": "1265939672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 OAK VALLEY DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633763721",
            "telephone_number": "636-443-3704",
            "fax_number": "636-294-0530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 LINCOLN ST",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633661603",
            "telephone_number": "636-443-3704",
            "fax_number": "636-294-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE WELL BALANCED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-11",
        "last_updated": "2018-04-11",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-443-3704",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2013045632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Levins, PHARMD
• Nat T Levy, MD
• Veda E Lewis-Simmons, DPM MHA LLC
• Taryn Lewis, D.C.
• Licensed Professional Counseling Services, LLC
• Lifetime Dental Care of Missouri, Richard Straus, D.M.D., P.C. (Premier Dental Partners O'Fallon)
• Limitless Physical Therapy LLC
• Sneha Lin, O.D.
• Anthony Lindahl, DMD
• Loria A Lindsey, M.D.

• Clinical Social Worker in O'Fallon, MO
• Providers in O'Fallon, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; 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.