Authentic Balance Consortium LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

001484 Issued in CT

Legal business name

AUTHENTIC BALANCE CONSORTIUM LLC

Practice address

267 Willimantic Rd
Suite 5
Chaplin, CT 06235-2516

Phone

(860) 617-2848

NPI assigned

Feb 4, 2008

Last updated

Feb 4, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Diane Tarricone, LPC

Title

Partner

Phone

(860) 617-2848

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jara J Messere, LCSW

  • Clinical Social Worker
  • Chaplin, CT
  • NPI 1639378953
  NPD (past)

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202083200000",
    "number": "1538347349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 WILLIMANTIC RD",
            "address_2": "SUITE 5",
            "city": "CHAPLIN",
            "state": "CT",
            "postal_code": "062352516",
            "telephone_number": "860-617-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 WILLIMANTIC RD",
            "address_2": "SUITE 5",
            "city": "CHAPLIN",
            "state": "CT",
            "postal_code": "062352516",
            "telephone_number": "860-617-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTHENTIC BALANCE CONSORTIUM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-04",
        "last_updated": "2008-02-04",
        "status": "A",
        "authorized_official_last_name": "TARRICONE",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "860-617-2848",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "001484",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006609",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Ann Mahoney Butcka
• Chaplin Public Schools
• Elizabeth H Flanagan, PH.D.
• Bert Dennis Gunn
• Interior Castle Counseling, LLC

• Professional Counselor in Chaplin, CT
• Providers in Chaplin, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.