Balancing Life Cycles, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2013032185 Issued in MO

Legal business name

BALANCING LIFE CYCLES, LLC

Practice address

500 Market St Ste 101
Fulton, MO 65251-2808

Phone

(573) 591-1514

Fax

(573) 642-0087

NPI assigned

Oct 10, 2017

Last updated

Oct 10, 2017By 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

Chanda L Herron, LCSWNPI 1225463490

Title

Owner

Phone

(573) 591-1514

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, and the practitioner matching its NPPES authorized official.

• Chanda L Herron, LCSW

  • Clinical Social Worker
  • Fulton, MO
  • NPI 1225463490
  Authorized official Same address or phone

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

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507593600000",
    "number": "1568972107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MARKET ST STE 101",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652512808",
            "telephone_number": "573-591-1514",
            "fax_number": "573-642-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MARKET ST STE 101",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652512808",
            "telephone_number": "573-591-1514",
            "fax_number": "573-642-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCING LIFE CYCLES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-10",
        "last_updated": "2017-10-10",
        "status": "A",
        "authorized_official_last_name": "HERRON",
        "authorized_official_first_name": "CHANDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-591-1514",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2013032185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Fulton, MO
• Providers in Fulton, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2017; 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.