Balanced Living Therapy, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BALANCED LIVING THERAPY, LLC

Practice address

142 Ramsdell St
New Haven, CT 06515-1614

Phone

(203) 645-3887

NPI assigned

May 17, 2022

Last updated

May 17, 2022By 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

Mrs. Angela Avery, LCSWNPI 1588272744

Title

Owner

Phone

(203) 645-3887

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.

• Angela Monique Avery, LCSW

  • Clinical Social Worker
  • New Haven, CT
  • NPI 1588272744
  NPD Authorized official

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

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652745600000",
    "number": "1336886704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 RAMSDELL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065151614",
            "telephone_number": "203-645-3887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 RAMSDELL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065151614",
            "telephone_number": "203-645-3887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED LIVING THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-17",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A",
        "authorized_official_last_name": "AVERY",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-645-3887",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "HIE",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "142 Ramsdell St",
            "city": "New Haven",
            "state": "CT",
            "country_code": "US",
            "postal_code": "065151614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stuart M Baker, LADC
• Suher Baker, BDS, DMD, MS
• Christine Bakhoum
• Leen Bakkali, MD
• Nitya Bakshi, MD
• Balanced Path Mental Health PLLC
• Bienvinido Arias Balaoing
• Priyadarshini Balasubramanian, M.D.
• Lilanthi Balasuriya, M.D.
• Raisa Ideliss Balbuena Merle, M.D.

• Clinical Social Worker in New Haven, CT
• Providers in New Haven, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; 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.