The Balanced Lifestyle GRP., LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I 0600003 Issued in OH

Legal business name

THE BALANCED LIFESTYLE GRP., LLC

Practice address

1721 Dana Ave
Cincinnati, OH 45207-1138

Phone

(513) 731-4004

Fax

(513) 731-4005

NPI assigned

Jan 28, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Constance L. Bates, LISW-SNPI 1982656856

Title

Psychotherapist

Phone

(513) 731-4909

Specialties & licenses 1

Addresses

Practitioners 1

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

• Constance Lynn Bates, LISW

  • Clinical Social Worker
  • Cincinnati, OH
  • NPI 1982656856
  NPD (past) Authorized official

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

{
    "created_epoch": "1233100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233100800000",
    "number": "1508004664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 DANA AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452071138",
            "telephone_number": "513-731-4004",
            "fax_number": "513-731-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 DANA AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452071138",
            "telephone_number": "513-731-4004",
            "fax_number": "513-731-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BALANCED LIFESTYLE GRP., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-28",
        "last_updated": "2009-01-28",
        "status": "A",
        "authorized_official_last_name": "BATES",
        "authorized_official_first_name": "CONSTANCE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "513-731-4909",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LISW-S"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I 0600003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; 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.