Health Balance International

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

HEALTH BALANCE INTERNATIONAL

Practice address

1627 Foothill Dr
Suite 10
Salt Lake City, UT 84108-2739

Phone

(801) 688-2628

NPI assigned

Sep 11, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Charles McCusker

Title

Manager

Phone

(801) 688-2628

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221091200000",
    "number": "1467601674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1627 FOOTHILL DR",
            "address_2": "SUITE 10",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841082739",
            "telephone_number": "801-688-2628",
            "fax_number": "801-906-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 FOOTHILL DR",
            "address_2": "SUITE 10",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841082739",
            "telephone_number": "801-688-2628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH BALANCE INTERNATIONAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-11",
        "last_updated": "2008-09-11",
        "status": "A",
        "authorized_official_last_name": "MCCUSKER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "801-688-2628",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2008; 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.