Organization Active NPI

Balance Therapy LLC

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1568243624
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
BALANCE THERAPY LLC
Doing business as
Balance Therapy LLC
Practice address
16914 Silverwood Dr
San Antonio, TX 78232-2321
Phone
(210) 793-3311
NPI assigned
Oct 13, 2023
Last updated
Oct 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Authorized official

Name
Myriam Liliana Liliana Bermudez, LPC
Title
Owner
Phone
(210) 793-3311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

16914 Silverwood Dr
San Antonio, TX 78232-2321

Mailing address

16914 Silverwood Dr
San Antonio, TX 78232-2321
Phone (210) 793-3311

Other identifiers 1

IdentifierTypeStateIssuer
1952044612OtherTXLPC

Other names 1

  • Balance Therapy LLC Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.holabalance.com/therapy Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240125000368 TX Part B Supplier - Clinic/Group Practice 8224481338 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1697155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697414400000",
    "number": "1568243624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16914 SILVERWOOD DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782322321",
            "telephone_number": "210-793-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16914 SILVERWOOD DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782322321",
            "telephone_number": "210-793-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-13",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A",
        "authorized_official_last_name": "BERMUDEZ",
        "authorized_official_first_name": "MYRIAM LILIANA",
        "authorized_official_middle_name": "LILIANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-793-3311",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC",
            "identifier": "1952044612",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.holabalance.com/therapy",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "website",
            "address_1": "16914 Silverwood Dr",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782322321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Balance Therapy LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Balance Therapy LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.