True Balance Wellness Group

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

TRUE BALANCE WELLNESS GROUP

Practice address

725 River Rd Ste 32-249
Edgewater, NJ 07020-1171

Phone

(201) 397-5662

NPI assigned

Apr 25, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Leyla Mata, LPCNPI 1366730970

Title

Owner/Therapist

Phone

(201) 397-5662

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• True Balance Wellness Group Former legal business name

Practitioners 1

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

• Leyla Amanda Mata, M.A., ED.M, L.P.C.

  • Professional Counselor
  • Fort Lee, NJ
  • NPI 1366730970
  NPD Authorized official

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

{
    "created_epoch": "1619308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619308800000",
    "number": "1447832829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 RIVER RD STE 32-249",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201171",
            "telephone_number": "201-397-5662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 RIVER RD STE 32-249",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201171",
            "telephone_number": "201-397-5662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUE BALANCE WELLNESS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-25",
        "last_updated": "2021-04-25",
        "certification_date": "2021-04-25",
        "status": "A",
        "authorized_official_last_name": "MATA",
        "authorized_official_first_name": "LEYLA",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "201-397-5662",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1366730970",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "True Balance Wellness Group",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2021; 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.