A Balanced Mind, LLC
Organization Active NPI Clinical Social Worker · Harrisonville, MO
NPI 1396113643 · NPPES record last updated Jan 12, 2024
Key facts
- NPI
- 1396113643
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Legal business name
- A BALANCED MIND, LLC
- Practice address
- 1300 Locust St Ste E
Harrisonville, MO 64701-1366 - Phone
- (816) 884-4004
- Fax
- (816) 884-3414
- NPI assigned
- Sep 3, 2015
- Organization subpart
- No
Authorized official
- Name
- Mrs. Aimee Johnson, LCSW
- Title
- Licensed Clincal Social Worker
- Phone
- (816) 884-4004
Practitioners 2
-
Aimee Johnson, LCSW, LSCSW
-
Dwila Cox, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20151211002090 | MO | Part B Supplier - Clinic/Group Practice | 3375844574 |
Receives reassigned benefits from 1 practitioner Practice locations: Belton, MO |
National Provider Directory
Locations
111 Bradford Ln
Belton, MO 64012
Phone (816) 884-4004
1300 Locust St
Ste E
Harrisonville, MO 64701
Phone (816) 738-1545
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | Yes |
Addresses
Primary practice location
1300 Locust St Ste E
Harrisonville, MO 64701-1366
Mailing address
1300 Locust St Ste E
Harrisonville, MO 64701-1366
Phone (816) 884-4004
Other providers in Harrisonville, MO
- ABA Up and Up Mo LLC
- Absolute Health Chiropractic Inc
- Gina Marie Accurso-Lee
- Acute Care Billing Mo, LLC
- Brittany Adams
All providers in Harrisonville, MO · Clinical Social Worker in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.