Individual provider Active NPI

Gabrielle Chanell Balancier

  • Mental Health Counselor
  • Tampa, FL
National Provider Identifier
1457997207
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH18910 Issued in FL
Practice address
10909 Memorial Hwy
Tampa, FL 33615-2511
Phone
(985) 788-4502
NPI assigned
Nov 26, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMH18910 FL Primary

Addresses

Primary practice location

10909 Memorial Hwy
Tampa, FL 33615-2511

Mailing address

13375 Arbor Pointe Cir Apt 101
Tampa, FL 33617-1141
Phone (985) 788-4502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
IMH18910FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1574726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1457997207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13375 ARBOR POINTE CIR APT 101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336171141",
            "telephone_number": "985-788-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10909 MEMORIAL HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336152511",
            "telephone_number": "985-788-4502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALANCIER",
        "first_name": "GABRIELLE",
        "middle_name": "CHANELL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-26",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH18910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; 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.